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General NPI Number Information
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NPI Number | 1568810935
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Entity Type | Individual
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Provider Name | CANDACE MARIE BROUSSARD-STEINBERG MD
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Gender | Female
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 1250 HANCOCK ST STE 505S
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City | QUINCY
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State | MA
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Zip | 02169-4339
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Country | US
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Telephone | 781-253-7165
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Fax | 781-253-7166
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Provider Business Mailing Address
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Address Line | 1250 HANCOCK ST STE 505S
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City | QUINCY
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State | MA
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Zip | 02169-4339
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Country | US
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Telephone | 781-253-7165
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Fax | 781-253-7166
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 1017761
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 01084188A
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License Number State | IN
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