1417987231 NPI number — DR. ELIZABETH AQUINO GARCIA-JANIS MD

Table of content: DR. ELIZABETH AQUINO GARCIA-JANIS MD (NPI 1417987231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417987231 NPI number — DR. ELIZABETH AQUINO GARCIA-JANIS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA-JANIS
Provider First Name:
ELIZABETH
Provider Middle Name:
AQUINO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARCIA-GRAY
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
A.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417987231
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23402 MINERAL LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILL CITY
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57745-6617
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-441-7803
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23402 MINERAL LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HILL CITY
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57745-6617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-441-7803
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0804X , with the licence number:  4301100092 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: DR.0052141 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: 01033027A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: 21686 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: 9235 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: MD-17894 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)