Individual
NICOLE LAUREN CANDRILLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,L.AC
Contact information
Practice address
4454 AUSTIN BLVD, ISLAND PARK, NY 11558-1621
(646) 872-1985
Mailing address
120 MITCHELL AVE, LONG BEACH, NY 11561-3860
(646) 872-1985
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006059
NY
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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