Provider Demographics
NPI:1588760912
Name:GARCIA, ELIZABETH (MD FACOG FACS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD FACOG FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 PARROTT PLACE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228
Mailing Address - Country:US
Mailing Address - Phone:718-238-9201
Mailing Address - Fax:718-745-3898
Practice Address - Street 1:84 PARROTT PLACE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228
Practice Address - Country:US
Practice Address - Phone:718-238-9201
Practice Address - Fax:718-745-3898
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111575207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP369169OtherOXFORD
NY0299520OtherGHI
NY653301Medicare ID - Type Unspecified
B17556Medicare UPIN