=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558076745
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBIN GARCIA R.PH.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/23/2023
-----------------------------------------------------
Last Update Date | 01/23/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5301 BROADWAY
-----------------------------------------------------
City | WEST NEW YORK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07093-2622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-520-9364
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1628 VALLEY ST APT 1D
-----------------------------------------------------
City | FORT LEE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07024-2530
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-232-6620
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RI20872
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------