Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 1707171 | NY |
NPI | 1003923103 |
---|---|
Provider Name | Dr. Michael M Candaras |
First Address | Irving, NY 14081 |
Second Address | Irving, NY 14081 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01270584 | (05) | NY |
0506099 | IHA (01) | NY |
E15580 | (02) |