Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | N007006 | NY |
N | 222Z00000X | Podiatrist | N007006 | NY |
N | 213EP1101X | Primary Podiatric Medicine | N007006 | NY |
N | 213ES0131X | Foot Surgery | N007006 | NY |
NPI | 1417307927 |
---|---|
Provider Name | Dr. Thomas Lawrence Candara |
First Address | Cohoes, NY 12047-4848 |
Second Address | Castleton, NY 12033-9584 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2016 |
Last Update Date | 29/08/2019 |