Provider Demographics
NPI:1518569631
Name:CANDO, PAMELA A (RD, CDN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:CANDO
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9930 63RD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2955
Mailing Address - Country:US
Mailing Address - Phone:929-266-5422
Mailing Address - Fax:
Practice Address - Street 1:9930 63RD AVE APT 2
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2955
Practice Address - Country:US
Practice Address - Phone:929-266-5422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered