1528220811 NPI number — MS. JOANNE HAZEL GARCIA

Table of content: MS. JOANNE HAZEL GARCIA (NPI 1528220811)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528220811 NPI number — MS. JOANNE HAZEL GARCIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
JOANNE
Provider Middle Name:
HAZEL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JUDAN
Provider Other First Name:
JOANNE
Provider Other Middle Name:
HAZEL
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPA-C
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1528220811
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
85-51 150TH STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIARWOOD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11435
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
525 E 68TH STREET
Provider Second Line Business Practice Location Address:
NEW YORK PRESBYTERIAN - WEIL CORNELL MEDICAL CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-746-4935
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2008

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: 363AM0700X , with the licence number:  009717 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 160988442 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".