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Individual

MRS. JEANINE MARIE CELIE CANTAVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
750 FULTON ST, FARMINGDALE, NY 11735-3642
(631) 249-2765
(631) 249-3617
Mailing address
750 FULTON ST, FARMINGDALE, NY 11735-3642
(631) 249-2765
(631) 249-3617

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
193978
NY
2084P0800X
Psychiatry Physician
ME85886
FL

Other

Enumeration date
09/07/2005
Last updated
04/08/2008
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