Healthcare Provider Details

I. General information

NPI: 1770120313
Provider Name (Legal Business Name): NINA ERIKA HUGO GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 12/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1371 SEABURY AVE
BRONX NY
10461-3629
US

IV. Provider business mailing address

1371 SEABURY AVE
BRONX NY
10461-3629
US

V. Phone/Fax

Practice location:
  • Phone: 718-841-7026
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number709316-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: