Individual
CANDICE HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 STEVEN PL, CORAM, NY 11727-4500
(631) 612-0320
Mailing address
12 STEVEN PL, CORAM, NY 11727-4500
(631) 612-0320
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
348975-01
NY
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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