Healthcare Provider Details

I. General information

NPI: 1417201682
Provider Name (Legal Business Name): HC GARCIA PHYSICIAN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2012
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 HONE AVE
BRONX NY
10461-1406
US

IV. Provider business mailing address

23405 88TH AVE
QUEENS VILLAGE NY
11427-2707
US

V. Phone/Fax

Practice location:
  • Phone: 718-823-9543
  • Fax: 718-823-5757
Mailing address:
  • Phone: 718-347-3240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number197478-1
License Number StateNY

VIII. Authorized Official

Name: DR. HORTENCIA C GARCIA
Title or Position: OWNER
Credential: M.D.
Phone: 718-347-3240