Provider Demographics
NPI:1063531564
Name:GARCIA, DAVID EMILIO (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EMILIO
Last Name:GARCIA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:30-85 VERNON BOULEVARD APT 2-E
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102
Mailing Address - Country:US
Mailing Address - Phone:347-527-1541
Mailing Address - Fax:347-527-1541
Practice Address - Street 1:1998 BRUCKNER BOULEVARD
Practice Address - Street 2:LENS LAB EXPRESS
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473
Practice Address - Country:US
Practice Address - Phone:718-430-9776
Practice Address - Fax:718-863-6623
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYTUV005844152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist