Provider Demographics
NPI:1699206466
Name:HATTEN-POWELL, CANDACE YVETTE (MD)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:YVETTE
Last Name:HATTEN-POWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:YVETTE
Other - Last Name:HATTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:111 E 210TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2401
Mailing Address - Country:US
Mailing Address - Phone:718-920-7967
Mailing Address - Fax:718-882-3185
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-7967
Practice Address - Fax:718-882-3185
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program