MEDICARE: CHRISTINE JACQUELINE KANTOR OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TA2799	MD
2	152W00000X	Optometrist	TPOP54	FL
3	152WC0802X	Corneal and Contact Management Optometrist	TUV007056	NY
4	152W00000X	Optometrist	OEG003769	PA
5	152W00000X	Optometrist	OPT.007357	OH
6	152W00000X	Optometrist	18004568A	IN
7	152W00000X	Optometrist	3876-35	WI
8	152WC0802X	Corneal and Contact Management Optometrist	002697	CT
9	152W00000X	Optometrist	21338-875	WI
10	152W00000X	Optometrist	27OA00624600	NJ
11	152W00000X	Optometrist	0618003056	VA

General Provider Information

NPI Number	:	1235145764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE JACQUELINE KANTOR OD

Provider Business Mailing Address
First Line	:	41 W PUTNAM AVE
Second Line	:
City	:	GREENWICH
State	:	CT
Zip	:	06830-5300
Country	:	US
Telephone Number	:	203-869-2255
Fax Number	:	203-869-0333

Provider Business Practice Location Address
First Line	:	41 W PUTNAM AVE
Second Line	:
City	:	GREENWICH
State	:	CT
Zip	:	06830-5300
Country	:	US
Telephone Number	:	203-869-2255
Fax Number	:	203-869-0333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	12/16/2025

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