Healthcare Provider Details

I. General information

NPI: 1457279937
Provider Name (Legal Business Name): RAUL D GARCIA PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 UNION AVE APT 2Y
BROOKLYN NY
11211-1378
US

IV. Provider business mailing address

544 UNION AVE APT 2Y
BROOKLYN NY
11211-1378
US

V. Phone/Fax

Practice location:
  • Phone: 917-698-3931
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number028340
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: