Individual
JINGLE CANDELASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 VICTORY BLVD. APT 5L, STATEN ISLAND, NY 10301
(646) 455-7125
Mailing address
800 VICTORY BLVD APT 5L, STATEN ISLAND, NY 10301-3710
(646) 455-7125
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
031426-1
NY
2251P0200X
Pediatric Physical Therapist
Primary
031426-1
NY
Other
Enumeration date
03/24/2014
Last updated
03/24/2014
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