Provider Demographics
NPI:1811278229
Name:GOIN, CANDACE MARIE (LPN)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:MARIE
Last Name:GOIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537A INDIAN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:PINE BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12566-5411
Mailing Address - Country:US
Mailing Address - Phone:845-313-2954
Mailing Address - Fax:
Practice Address - Street 1:1537A INDIAN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:PINE BUSH
Practice Address - State:NY
Practice Address - Zip Code:12566-5411
Practice Address - Country:US
Practice Address - Phone:845-313-2954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277246-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse