Basic Information
Provider Information
NPI: 1003001371
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KANTER
FirstName: DAVID
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 750 E ADAMS ST
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132102342
CountryCode: US
TelephoneNumber: 3154645820
FaxNumber: 3154648699
Practice Location
Address1: 750 E ADAMS ST
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132102342
CountryCode: US
TelephoneNumber: 3154645820
FaxNumber: 3154648699
Other Information
ProviderEnumerationDate: 09/10/2007
LastUpdateDate: 05/06/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000X245581-1NYY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

ID Information
IDTypeStateIssuerDescription
0292539505NY MEDICAID


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