Individual
CANDACE TIFFANY LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 E 72ND ST APT 2, BROOKLYN, NY 11234-5456
(917) 488-7764
Mailing address
1111 E 72ND ST APT 2, BROOKLYN, NY 11234-5456
(917) 488-7764
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
770340-1
NY
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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