Provider Demographics
NPI:1851361265
Name:CANDE, ANGELINA TERESA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELINA
Middle Name:TERESA
Last Name:CANDE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 S RIVER RD
Mailing Address - Street 2:BEDFORD PLACE #58
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6719
Mailing Address - Country:US
Mailing Address - Phone:603-626-4205
Mailing Address - Fax:603-666-6617
Practice Address - Street 1:40 S RIVER RD
Practice Address - Street 2:BEDFORD PLACE #58
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6719
Practice Address - Country:US
Practice Address - Phone:603-626-4205
Practice Address - Fax:603-666-6617
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2808225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30392380Medicaid
NHRE5412Medicare ID - Type Unspecified