Provider Demographics
NPI:1023399318
Name:CANDESCENT EYE SURGICENTER LLC
Entity Type:Organization
Organization Name:CANDESCENT EYE SURGICENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:COREY
Authorized Official - Middle Name:B
Authorized Official - Last Name:WESTERFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-910-2204
Mailing Address - Street 1:51 STATE RD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-3319
Mailing Address - Country:US
Mailing Address - Phone:774-320-3040
Mailing Address - Fax:508-910-2204
Practice Address - Street 1:444 QUAKER LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-0185
Practice Address - Country:US
Practice Address - Phone:401-384-6537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPENDING261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical