Individual
CANDACE CARABALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 WEBSTER AVE, JERSEY CITY, NJ 07307-1631
(201) 589-8621
Mailing address
115 WEBSTER AVE, JERSEY CITY, NJ 07307-1631
(201) 589-8621
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
317752-1
NY
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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