Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 152615-1 | NY |
NPI | 1306951371 |
---|---|
Provider Name | Brian Mccandless |
First Address | Cohoes, NY 12047-3049 |
Second Address | Clifton Park, NY 12065-3763 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 29/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01032824 | (05) | NY |
B82889 | (02) |