Healthcare Provider Details

I. General information

NPI: 1942343173
Provider Name (Legal Business Name): RICHARD LOUIS CANALY LPTA RN BSN NY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 BELMORE RD CANDLEWOOD PARK HEALTHCARE CENTERS
EAST CLEVELAND OH
44112
US

IV. Provider business mailing address

15798 BIRCHCROFT DR
BROOK PARK OH
44142
US

V. Phone/Fax

Practice location:
  • Phone: 216-268-3600
  • Fax: 216-761-1322
Mailing address:
  • Phone: 216-265-9245
  • Fax: 216-265-9245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number258018
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number00883
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: