1992853634 NPI number — SANDRA PATRICIA GARCIA DPM PC

Table of content: (NPI 1992853634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992853634 NPI number — SANDRA PATRICIA GARCIA DPM PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANDRA PATRICIA GARCIA DPM PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992853634
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7802 65TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11385-6804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-434-8302
Provider Business Mailing Address Fax Number:
718-709-7652

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4331 KISSENA BLVD
Provider Second Line Business Practice Location Address:
STREET LEVEL
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355-2921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-434-8302
Provider Business Practice Location Address Fax Number:
718-709-7652
Provider Enumeration Date:
01/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GARCIA
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
PATRICIA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
917-434-8302

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  N005534 , 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)





Copyright © 2007-2025 www.npivalidator.com