Healthcare Provider Details

I. General information

NPI: 1851186845
Provider Name (Legal Business Name): JOSHUA JONATHAN GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 HUNTINGTON AVE
BOSTON MA
02115-5005
US

IV. Provider business mailing address

152 TIMBERLINE DR
BRENTWOOD NY
11717-5717
US

V. Phone/Fax

Practice location:
  • Phone: 617-373-2000
  • Fax:
Mailing address:
  • Phone: 631-816-9680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: