Healthcare Provider Details

I. General information

NPI: 1629383203
Provider Name (Legal Business Name): PATRICIA GARNICA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2010
Last Update Date: 03/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 SAINT NICHOLAS AVE 2ND FLOOR
NEW YORK NY
10032-3822
US

IV. Provider business mailing address

1150 SAINT NICHOLAS AVE 2ND FLOOR
NEW YORK NY
10032-3822
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-7838
  • Fax: 212-851-5485
Mailing address:
  • Phone: 212-305-7838
  • Fax: 212-851-5485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF305377-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number423137-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: