Individual
MS. CANDYCE FAHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN IBCLC
Contact information
Practice address
22 HAIG AVE, E PATCHOGUE, NY 11772
(631) 730-2993
Mailing address
22 HAIG AVE, E PATCHOGUE, NY 11772
(631) 730-2993
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN309353
NY
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L20013
NY
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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