Individual
MARY CANDIDA TSIDEMIDIS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
295 7TH AVE, SAINT JAMES, NY 11780-2436
(631) 487-1627
Mailing address
56 KNOTT DR, GLEN COVE, NY 11542-4143
(516) 676-5965
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
336883-01
NY
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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