Provider Demographics
NPI:1487982542
Name:KANTAROWITZ, NATALIYA (MS)
Entity type:Individual
Prefix:MRS
First Name:NATALIYA
Middle Name:
Last Name:KANTAROWITZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7602 21ST AVE APT 4I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1339
Mailing Address - Country:US
Mailing Address - Phone:718-490-1675
Mailing Address - Fax:
Practice Address - Street 1:83 MARLBOROUGH RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4301
Practice Address - Country:US
Practice Address - Phone:718-284-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY375867091103K00000X
NY231169081174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst