Provider Demographics
NPI:1881013878
Name:FOY, CANDICE MAIETTI (MD)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:MAIETTI
Last Name:FOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 NICOLLS RD # 11
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-444-7692
Mailing Address - Fax:631-444-7292
Practice Address - Street 1:100 NICOLLS RD # LEVEL11N
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-1559
Practice Address - Country:US
Practice Address - Phone:631-444-7884
Practice Address - Fax:631-444-8968
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY284064208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics