Healthcare Provider Details

I. General information

NPI: 1396661146
Provider Name (Legal Business Name): STEPHANIE PRISCILLA CANDO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15050 14TH RD
WHITESTONE NY
11357-2609
US

IV. Provider business mailing address

8018 89TH AVE
WOODHAVEN NY
11421-2424
US

V. Phone/Fax

Practice location:
  • Phone: 347-357-9910
  • Fax:
Mailing address:
  • Phone: 347-357-9910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: