| Etny Raul Candelario, MD | |
|
100 Perkins Farm Dr Ste 203, Mystic, CT 06355-4041 | |
| (860) 576-8911 | |
| (860) 572-7758 |
| Full Name | Etny Raul Candelario |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 7 Years |
| Location | 100 Perkins Farm Dr Ste 203, Mystic, Connecticut |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568084150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301510053 (Michigan) | Secondary |
| 207Q00000X | Family Medicine | U6458 (Texas) | Secondary |
| 207Q00000X | Family Medicine | 79070 (Connecticut) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lawrence & Memorial Hospital | New london, CT | Hospital |
| Westerly Hospital | Westerly, RI | Hospital |
| William W Backus Hospital | Norwich, CT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hartford Healthcare Medical Group Inc | 1153573902 | 223 |
| Entity Name | Hartford Healthcare Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043561301 PECOS PAC ID: 1153573902 Enrollment ID: O20121201000007 |
| Mailing Address | Practice Location Address |
|---|---|
| Etny Raul Candelario, MD 1339 Fair Ave, San Antonio, TX 78223-1437 Ph: (210) 923-4372 | Etny Raul Candelario, MD 100 Perkins Farm Dr Ste 203, Mystic, CT 06355-4041 Ph: (860) 576-8911 |
Dr. Harold Eugene Phillips Jr., M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3 Heron Rd, Mystic, CT 06355 Phone: 860-536-6442 Fax: 860-536-6442 | |
Dr. Sungsil Cho, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 23 Clara Dr, Mystic, CT 06355 Phone: 860-572-5782 | |
Brandi Lynn Iovino, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 41 E Main St, Mystic, CT 06355 Phone: 860-572-2988 | |
Dr. Michael J Feltes, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3 Heron Rd, Mystic, CT 06355 Phone: 860-536-6442 Fax: 860-536-6442 |