Healthcare Provider Details

I. General information

NPI: 1417307927
Provider Name (Legal Business Name): THOMAS LAWRENCE CANDARA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NORTHERN BLVD
ALBANY NY
12204-1004
US

IV. Provider business mailing address

5 SAND CREEK RD STE 200
ALBANY NY
12205-1400
US

V. Phone/Fax

Practice location:
  • Phone: 718-362-1406
  • Fax: 718-414-1651
Mailing address:
  • Phone: 518-459-0711
  • Fax: 518-275-0646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN007006
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: