Provider Demographics
NPI:1235572181
Name:CANDELA, JANINE M (RPH)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:M
Last Name:CANDELA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 NEPTUNE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6845
Mailing Address - Country:US
Mailing Address - Phone:908-487-1269
Mailing Address - Fax:
Practice Address - Street 1:308 NEPTUNE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6845
Practice Address - Country:US
Practice Address - Phone:908-487-1269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035800183500000X
NJRI01866800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist