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General NPI Number Information
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NPI Number | 1184338105
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Entity Type | Individual
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Provider Name | CEDRICK JAMES LIM GARCIA PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/13/2023
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON ROAD SUITE 5A43
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City | NEWARK
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State | DE
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Zip | 19718-2200
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Country | US
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Telephone | 302-623-0188
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Fax | 302-733-5640
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Provider Business Mailing Address
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Address Line | 3261 W STATE RD
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City | SAINT BONAVENTURE
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State | NY
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Zip | 14778-9800
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Country | US
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Telephone | 856-796-2118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0012116
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License Number State | DE
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