Healthcare Provider Details

I. General information

NPI: 1407936321
Provider Name (Legal Business Name): DANIEL GARZA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W 58TH ST STE 203
NEW YORK NY
10019-1822
US

IV. Provider business mailing address

601 W 57TH ST APT 26S
NEW YORK NY
10019-1288
US

V. Phone/Fax

Practice location:
  • Phone: 646-641-5564
  • Fax: 347-396-8996
Mailing address:
  • Phone: 466-415-5646
  • Fax: 463-968-9963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number185883
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: