Provider Demographics
NPI:1104180157
Name:GARCIA, HELEN GRACE
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:GRACE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:HELEN
Other - Middle Name:GRACE
Other - Last Name:GARCIA-LOPEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3165 DECATUR AVE
Mailing Address - Street 2:APT 6C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-4512
Mailing Address - Country:US
Mailing Address - Phone:917-359-3470
Mailing Address - Fax:
Practice Address - Street 1:1890 PALMER AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3059
Practice Address - Country:US
Practice Address - Phone:914-833-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2197915252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency