Individual provider · Type 1 NPI

Candice Grogan

Specialist · Ronkonkoma, NY

NPI number 1417622192 Active

Practice location

90 Air Park Dr
Ronkonkoma, NY 11779-7360

Call (631) 580-4001 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X1400608 (NY)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1417622192

Candice Grogan's National Provider Identifier is 1417622192, issued on Aug 13, 2021. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Ronkonkoma, NY. The record was last updated on Aug 13, 2021.