Individual
DR. CANDIDO E FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 NEW YORK AVE, 1W, HUNTINGTON, NY 11743-2743
(631) 385-9377
(631) 385-4372
Mailing address
120 NEW YORK AVE, 1W, HUNTINGTON, NY 11743-2743
(631) 385-9377
(631) 385-4372
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
148869
NY
Other
Enumeration date
11/02/2006
Last updated
10/12/2010
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