Provider Demographics
NPI:1598927857
Name:FRANK M.CANDIDO,M.D., P.A.
Entity Type:Organization
Organization Name:FRANK M.CANDIDO,M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CANDIDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-265-4050
Mailing Address - Street 1:466 OLD HOOK RD
Mailing Address - Street 2:SUITE 11& 12
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1396
Mailing Address - Country:US
Mailing Address - Phone:201-265-4050
Mailing Address - Fax:
Practice Address - Street 1:466 OLD HOOK RD
Practice Address - Street 2:SUITE 11& 12
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1396
Practice Address - Country:US
Practice Address - Phone:201-265-4050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA33992207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1051601Medicaid
NJC54985Medicare UPIN
NJ449773Medicare PIN