Provider Demographics
NPI:1811258155
Name:GARCIA, ROXANNA M (AGPCNP)
Entity type:Individual
Prefix:
First Name:ROXANNA
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15350 89TH AVE APT 920
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3891
Mailing Address - Country:US
Mailing Address - Phone:476-853-2403
Mailing Address - Fax:
Practice Address - Street 1:35 N TYSON AVE STE 100
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1469
Practice Address - Country:US
Practice Address - Phone:718-276-7935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312238363LA2200X
NY656337163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY656337OtherREGISTERED NURSE