Individual
GRACE S CANDELARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 DRIVING PARK AVE, NEWARK, NY 14513-1057
(585) 922-5067
Mailing address
1200 DRIVING PARK AVE, NEWARK, NY 14513-1057
(585) 922-5067
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
234879-1
NY
208M00000X
Hospitalist Physician
Primary
234879
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02640215
—
NY
Enumeration date
07/08/2006
Last updated
11/13/2012
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