Healthcare Provider Details

I. General information

NPI: 1750766028
Provider Name (Legal Business Name): RHEU CRISTINE BACAY CANDAVA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MADISON AVE FL 2
MORRISTOWN NJ
07960-7337
US

IV. Provider business mailing address

465 SOUTH ST STE 103
MORRISTOWN NJ
07960-6442
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5676
  • Fax: 973-290-7365
Mailing address:
  • Phone: 973-971-5676
  • Fax: 973-290-7365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number295911
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number25MA12436700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: