Healthcare Provider Details

I. General information

NPI: 1790698314
Provider Name (Legal Business Name): DAVID T GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 MAIN ST
HACKENSACK NJ
07601-4858
US

IV. Provider business mailing address

293 GRANT AVE
NUTLEY NJ
07110-2817
US

V. Phone/Fax

Practice location:
  • Phone: 201-678-1802
  • Fax: 347-227-8334
Mailing address:
  • Phone: 646-522-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC01001900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: