Provider Demographics
NPI:1992044697
Name:GARCIA, TANIA
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W 166TH ST
Mailing Address - Street 2:APT. 4A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-4515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 W 166TH ST
Practice Address - Street 2:APT. 4A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-4515
Practice Address - Country:US
Practice Address - Phone:917-312-7682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist