Healthcare Provider Details

I. General information

NPI: 1295013357
Provider Name (Legal Business Name): MARY ANGELYNNE GARCIA ESQUIVEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 9TH AVE
ALTOONA PA
16602-2415
US

IV. Provider business mailing address

709 HOLLIDAY HILLS DR
HOLLIDAYSBURG PA
16648-3218
US

V. Phone/Fax

Practice location:
  • Phone: 814-949-7622
  • Fax:
Mailing address:
  • Phone: 310-975-5485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD460449
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: