Individual
CANDACE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 E 165TH ST, BRONX, NY 10456-6657
(347) 251-0288
Mailing address
500 E 165TH ST, BRONX, NY 10456-6657
(347) 251-0288
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
348720
NY
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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