Provider Demographics
NPI:1053862599
Name:GARCIA, ALEXANDRA
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BILLS PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2104
Mailing Address - Country:US
Mailing Address - Phone:347-967-2651
Mailing Address - Fax:
Practice Address - Street 1:530 3RD AVE
Practice Address - Street 2:SUITE 5R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4651
Practice Address - Country:US
Practice Address - Phone:718-369-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005857171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist