Provider Demographics
NPI:1063848026
Name:CANDELA, JULIANNA (NP)
Entity Type:Individual
Prefix:MISS
First Name:JULIANNA
Middle Name:
Last Name:CANDELA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 WATERS PL
Mailing Address - Street 2:M-104
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2728
Mailing Address - Country:US
Mailing Address - Phone:718-794-1200
Mailing Address - Fax:718-794-1222
Practice Address - Street 1:1200 WATERS PL
Practice Address - Street 2:M-104
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2728
Practice Address - Country:US
Practice Address - Phone:718-794-1200
Practice Address - Fax:718-794-1222
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338318-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily