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NPI Code Detail

MEDICARE: JOANNE LEE CANDELA NP

MEDICARE: JOANNE LEE CANDELA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner302589NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1302589OTHERNYNYS NP LICENSE

General Provider Information

NPI Number : 1194897348
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNE LEE CANDELA NP
Provider Business Mailing Address
First Line : 300 E 66TH ST FL 9
Second Line :
City : NEW YORK
State : NY
Zip : 10065-6800
Country : US
Telephone Number : 646-888-4730
Fax Number :
Provider Business Practice Location Address
First Line : 300 E 66TH ST FL 9
Second Line :
City : NEW YORK
State : NY
Zip : 10065-6800
Country : US
Telephone Number : 646-888-4730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 09/19/2011

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