Provider Demographics
NPI:1285073932
Name:GARCIA, ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 MOUNT SINAI CORAM RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1836
Mailing Address - Country:US
Mailing Address - Phone:631-504-1646
Mailing Address - Fax:
Practice Address - Street 1:207 HALLOCK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3033
Practice Address - Country:US
Practice Address - Phone:631-689-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY603575163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health