MEDICARE: MS. PATRICIA GARCIA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC05355500	NJ

General Provider Information

NPI Number	:	1184744534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA GARCIA LCSW

Provider Business Mailing Address
First Line	:	420 GORGE RD
Second Line	:
City	:	CLIFFSIDE PARK
State	:	NJ
Zip	:	07010-2826
Country	:	US
Telephone Number	:	201-943-8086
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 GORGE RD
Second Line	:
City	:	CLIFFSIDE PARK
State	:	NJ
Zip	:	07010-2826
Country	:	US
Telephone Number	:	201-943-8086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	03/16/2010

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