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General NPI Number Information
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NPI Number | 1972622918
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Entity Type | Organization
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Legal Business Name | JUAN CARLOS GARCIA, PLLC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 102 PARK ST SUITE 202
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City | GLENS FALLS
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State | NY
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Zip | 12801-4449
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Country | US
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Telephone | 518-793-0475
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Fax | 518-793-6658
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Provider Business Mailing Address
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Address Line | 102 PARK ST SUITE 202
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City | GLENS FALLS
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State | NY
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Zip | 12801-4449
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Country | US
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Telephone | 518-793-0475
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Fax | 518-793-6658
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Authorized Official
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Title or Position | MD
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Name | DR. JUAN CARLOS GARCIA
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Credential | MD
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Telephone | 518-793-0475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 230363
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License Number State | NY
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