Provider Demographics
NPI:1659567063
Name:ACUNTO, CANDICE LUCILLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:LUCILLE
Last Name:ACUNTO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 JOAN CT
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-1213
Mailing Address - Country:US
Mailing Address - Phone:516-523-7064
Mailing Address - Fax:631-716-0087
Practice Address - Street 1:24 JOAN CT
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-1213
Practice Address - Country:US
Practice Address - Phone:516-523-7064
Practice Address - Fax:631-716-0087
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286478164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse