Individual
CANDIS MUSGRAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11143 180TH ST, JAMAICA, NY 11433-4130
(516) 444-8728
Mailing address
11143 180TH ST, JAMAICA, NY 11433-4130
(516) 444-8728
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1815524
NY
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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