MEDICARE: MAYRA L GARCIA RPH

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	183500000X	Pharmacist	034749	NY

General Provider Information

NPI Number	:	1659405611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYRA L GARCIA RPH

Provider Business Mailing Address
First Line	:	811 BEVERLEY RD APT 3R
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3322
Country	:	US
Telephone Number	:	718-724-4520
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 CRESCENT ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3802
Country	:	US
Telephone Number	:	718-391-0400
Fax Number	:	718-391-0777

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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