Individual
CANDACE ANN MOLLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 572-6131
(516) 572-5793
Mailing address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 572-6131
(516) 572-5793
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
004144-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004144-1
NY STATE LICENSE
NY
Enumeration date
05/11/2007
Last updated
07/08/2007
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