Provider Demographics
NPI:1013682905
Name:CANDRIA FOOT & ANKLE SPECIALISTS PLLC
Entity type:Organization
Organization Name:CANDRIA FOOT & ANKLE SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PASQUALE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANCELLIERE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:603-216-2972
Mailing Address - Street 1:25 BUTTRICK RD STE D1
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3353
Mailing Address - Country:US
Mailing Address - Phone:603-216-2972
Mailing Address - Fax:603-216-5675
Practice Address - Street 1:32 STILES RD STE 102
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2893
Practice Address - Country:US
Practice Address - Phone:603-328-8437
Practice Address - Fax:603-328-8554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty