MEDICARE: DIANELYS M GARCIA

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1356206759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANELYS M GARCIA

Provider Business Mailing Address
First Line	:	414 EDGEWOOD RD
Second Line	:
City	:	LINDEN
State	:	NJ
Zip	:	07036-5322
Country	:	US
Telephone Number	:	908-510-4464
Fax Number	:

Provider Business Practice Location Address
First Line	:	414 EDGEWOOD RD
Second Line	:
City	:	LINDEN
State	:	NJ
Zip	:	07036-5322
Country	:	US
Telephone Number	:	908-510-4464
Fax Number	:

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

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “ DIANELYS M GARCIA ” Practice Location

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