Individual
CANDICE G JERSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-1530
(860) 679-2147
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0002
(860) 679-2147
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
63814
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2016
Last updated
02/13/2023
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