Healthcare Provider Details

I. General information

NPI: 1013682905
Provider Name (Legal Business Name): CANDRIA FOOT & ANKLE SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 STILES RD STE 102
SALEM NH
03079-2893
US

IV. Provider business mailing address

25 BUTTRICK RD STE D1
LONDONDERRY NH
03053-3353
US

V. Phone/Fax

Practice location:
  • Phone: 603-328-8437
  • Fax: 603-328-8554
Mailing address:
  • Phone: 603-216-2972
  • Fax: 603-216-5675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PASQUALE CANCELLIERE
Title or Position: PODIATRIST, OWNER
Credential: DPM
Phone: 603-216-2972