Provider Demographics
NPI:1073675989
Name:GARCIA, LAURA ANN (ACNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CROSFIELD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2219
Mailing Address - Country:US
Mailing Address - Phone:845-353-4344
Mailing Address - Fax:845-348-1873
Practice Address - Street 1:2 CROSFIELD AVE STE 202
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2219
Practice Address - Country:US
Practice Address - Phone:845-353-4344
Practice Address - Fax:845-348-1873
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337589-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMG0450659OtherDEA
NYP14277Medicare UPIN