Provider Demographics
NPI:1003916545
Name:WARRICK, CANDACE (DPT)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:WARRICK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 GRAND CONCOURSE
Mailing Address - Street 2:BRONX-LEBANON HOSP CTR. DEPT PM & R
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-8202
Mailing Address - Country:US
Mailing Address - Phone:718-579-3940
Mailing Address - Fax:
Practice Address - Street 1:1775 GRAND CONCOURSE
Practice Address - Street 2:BRONX-LEBANON HOSP CTR. DEPT PM & R
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-8202
Practice Address - Country:US
Practice Address - Phone:718-579-3940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023668-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist