Provider Demographics
NPI:1073792354
Name:GARCIA, RONNIETTE CRISTINA
Entity Type:Individual
Prefix:DR
First Name:RONNIETTE
Middle Name:CRISTINA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:RONNIETTE
Other - Middle Name:CRISTINA
Other - Last Name:LEIFERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30 5TH AVE
Mailing Address - Street 2:APT 1K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8859
Mailing Address - Country:US
Mailing Address - Phone:212-533-7880
Mailing Address - Fax:212-533-0162
Practice Address - Street 1:30 5TH AVE
Practice Address - Street 2:APT 1K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8859
Practice Address - Country:US
Practice Address - Phone:212-533-7880
Practice Address - Fax:212-533-0162
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053697-11223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics