Provider Demographics
NPI:1417900796
Name:ALTMAN, CANDEDIA LEE (PA)
Entity Type:Individual
Prefix:MISS
First Name:CANDEDIA
Middle Name:LEE
Last Name:ALTMAN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:99 EAST STATE STREET
Mailing Address - Street 2:NATHAN LITTAUER HOSPITAL
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078
Mailing Address - Country:US
Mailing Address - Phone:518-775-4282
Mailing Address - Fax:518-775-4283
Practice Address - Street 1:99 EAST STATE STREET
Practice Address - Street 2:NATHAN LITTAUER HOSPITAL
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078
Practice Address - Country:US
Practice Address - Phone:518-775-4282
Practice Address - Fax:518-775-4283
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2015-05-08
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Provider Licenses
StateLicense IDTaxonomies
NY009921363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q17810Medicare UPIN