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General NPI Number Information
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NPI Number | 1629581392
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Entity Type | Organization
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Legal Business Name | STEPHANIE GARCIA
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 666 GLENBROOK RD
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City | STAMFORD
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State | CT
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Zip | 06906-1439
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Country | US
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Telephone | 475-422-2878
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Fax |
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Provider Business Mailing Address
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Address Line | 291 ELLSWORTH ST APT 1D
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City | BRIDGEPORT
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State | CT
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Zip | 06605-3130
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INSURANCE SPECIALIST
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Name | MICHELLE SANTIAGO
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Credential |
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Telephone | 203-278-9131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 3051
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License Number State | CT
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