Healthcare Provider Details

I. General information

NPI: 1760896500
Provider Name (Legal Business Name): RIABIANCA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4215 3RD AVE
BRONX NY
10457-4501
US

IV. Provider business mailing address

60 MADISON AVE FL 5
NEW YORK NY
10010-1600
US

V. Phone/Fax

Practice location:
  • Phone: 718-294-5891
  • Fax: 718-294-2468
Mailing address:
  • Phone: 212-545-2439
  • Fax: 646-312-0481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number282392
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA130797
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: