Provider Demographics
NPI:1033926258
Name:GARCIA, ALICE (NP PROVIDER)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:NP PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13234 114TH PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2327
Mailing Address - Country:US
Mailing Address - Phone:347-863-7731
Mailing Address - Fax:
Practice Address - Street 1:13234 114TH PL
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2327
Practice Address - Country:US
Practice Address - Phone:347-863-7731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311351363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health