Healthcare Provider Details

I. General information

NPI: 1164199451
Provider Name (Legal Business Name): CANDICE MARIE STONEMETZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 11/24/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 ALEXANDER ST STE 5000
ROCHESTER NY
14607-4064
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-8003
  • Fax: 585-922-8195
Mailing address:
  • Phone: 585-922-8003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number310473
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: