Candace Ann Mollo, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

004144-1 Issued in NY

Practice address

2201 Hempstead Tpke
East Meadow, NY 11554-1859

Phone

(516) 572-6131

Fax

(516) 572-5793

NPI assigned

May 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245445493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-6131",
            "fax_number": "516-572-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-6131",
            "fax_number": "516-572-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLO",
        "first_name": "CANDACE",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "004144-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "004144-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abdul Qudoos Iqbal Mohammed, MBBS
• Leena Mohan, M.D.
• Rajat Mohanka
• Kayvon Moin, MD
• Chelsey Mollin, LAC
• Ebube Molokwu, M.D.
• Gerald A Mondschein, M.D.
• Maxine Sue Montag
• Jesselyn Montano-Rojas
• Carlos Monteagudo, MD

• Physical Therapy Assistant in East Meadow, NY
• Providers in East Meadow, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.