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General NPI Number Information
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NPI Number | 1609180983
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Entity Type | Organization
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Legal Business Name | NICOLE GARCIA PHD LLC
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 8 HILLSIDE AVE SUITE 206
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2129
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Country | US
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Telephone | 917-723-9986
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Fax |
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Provider Business Mailing Address
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Address Line | 8 HILLSIDE AVE SUITE 206
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2129
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Country | US
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Telephone | 917-723-9986
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICOLE A GARCIA
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Credential | PHD LLC
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Telephone | 917-723-9986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 35SI00461100
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License Number State | NJ
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