Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Candice Grogan

Individual provider Specialist · NPI 1417622192

Candice Grogan is a Specialist in Ronkonkoma, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2021

Practice location Address checks out

90 Air Park Dr
Ronkonkoma, NY 11779-7360
Phone: (631) 580-4001
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 1400608 (NY)

Record details

NPI number1417622192
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 13, 2021
Last updated in NPPESAugust 13, 2021
Certification dateAugust 13, 2021
Mailing address90 Air Park Dr, Ronkonkoma, NY 11779-7360

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