Individual
MRS. ANNA LEA KANTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 ALLEN ST, SPRINGFIELD, MA 01118-1803
(413) 782-7646
Mailing address
1515 ALLAN STREET, SPRINGFIELD, MA 01118
(413) 782-7646
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
143670
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MK03513701
MASS CONTROLLED SUBSTANCE
MA
Enumeration date
08/17/2006
Last updated
07/08/2007
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