Provider Demographics
NPI:1932452737
Name:PARAGANO, CANDICE (LAC)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:PARAGANO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 TRUMBULL ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-6300
Mailing Address - Country:US
Mailing Address - Phone:203-980-5822
Mailing Address - Fax:
Practice Address - Street 1:22 TRUMBULL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-6300
Practice Address - Country:US
Practice Address - Phone:203-980-5822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000572171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist