Provider Demographics
NPI:1194903039
Name:GARCIA, NICOLE MARY (APRN - BC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:APRN - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E 70TH ST
Mailing Address - Street 2:STARR 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-9800
Mailing Address - Country:US
Mailing Address - Phone:212-746-2381
Mailing Address - Fax:212-746-6665
Practice Address - Street 1:520 E 70TH ST
Practice Address - Street 2:STARR 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-9800
Practice Address - Country:US
Practice Address - Phone:212-746-2381
Practice Address - Fax:212-746-6665
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304713-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health