MEDICARE: DIANA GARCIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1427705573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA GARCIA

Provider Business Mailing Address
First Line	:	4108 42ND ST APT 6G
Second Line	:
City	:	SUNNYSIDE
State	:	NY
Zip	:	11104-2740
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	455 N END AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10282-1131
Country	:	US
Telephone Number	:	917-522-2367
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2022
Last Update Date	:	03/08/2022

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Directions to “ DIANA GARCIA ” Practice Location

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