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General NPI Number Information
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NPI Number | 1841808631
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Entity Type | Individual
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Provider Name | GONZALO GARCIA OTR/L
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Gender | Male
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 7000 MATTHEW DR UNIT 7406
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City | ROCKAWAY
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State | NJ
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Zip | 07866-1250
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Country | US
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Telephone | 973-985-0483
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Fax |
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Provider Business Mailing Address
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Address Line | 54 PARK AVE APT 20
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City | VERONA
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State | NJ
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Zip | 07044-2445
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Country | US
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Telephone | 973-985-0483
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR00699400
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License Number State | NJ
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