Provider Demographics
NPI:1558762914
Name:CANDELLA, ERIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CANDELLA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W DIVISION ST
Mailing Address - Street 2:APARTMENT 19
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-1566
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 W DIVISION ST
Practice Address - Street 2:APARTMENT 19
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-1566
Practice Address - Country:US
Practice Address - Phone:585-802-9449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist