Provider Demographics
NPI:1124368618
Name:GARCIA-FARIA, ELSIE LUCIA RICARDOS (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELSIE LUCIA
Middle Name:RICARDOS
Last Name:GARCIA-FARIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1759 RALEIGH CT E
Mailing Address - Street 2:APT # 165 B
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-2666
Mailing Address - Country:US
Mailing Address - Phone:732-688-8312
Mailing Address - Fax:
Practice Address - Street 1:1759 RALEIGH CT E
Practice Address - Street 2:APT# 165B
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-2666
Practice Address - Country:US
Practice Address - Phone:732-688-8312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00418800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist