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General NPI Number Information
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NPI Number | 1376865758
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Entity Type | Organization
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Legal Business Name | JANE CANTOR, LLC
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Dates
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Enumeration Date | 02/25/2010
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 932 HUNGERFORD DRIVE SUITE 5B
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City | ROCKVILLE
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State | MD
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Zip | 20850-1750
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Country | US
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Telephone | 301-315-2435
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Fax | 301-365-6609
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Provider Business Mailing Address
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Address Line | 7200 LONGWOOD DRIVE
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City | BETHESDA
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State | MD
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Zip | 20817-2122
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Country | US
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Telephone | 301-315-2435
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Fax | 301-365-6609
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Authorized Official
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Title or Position | MSW
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Name | JANE CANTOR
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Credential |
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Telephone | 301-315-2435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 05801
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License Number State | MD
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