Individual
CANDICE IRENE SIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 WILLIS AVE, ROCHESTER, NY 14616-4611
(585) 233-4953
Mailing address
117 WILLIS AVE, ROCHESTER, NY 14616-4611
(585) 233-4953
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
348055
NY
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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