Provider Demographics
NPI:1275723231
Name:GARCIA, DANA GABRIELLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:GABRIELLE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:DANA
Other - Middle Name:GABRIELLE
Other - Last Name:CORTESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:150 N FINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-1686
Mailing Address - Country:US
Mailing Address - Phone:908-430-4266
Mailing Address - Fax:908-430-4269
Practice Address - Street 1:1777 HAMBURG TPKE
Practice Address - Street 2:SUITE 305
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5211
Practice Address - Country:US
Practice Address - Phone:973-831-6666
Practice Address - Fax:973-831-8661
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00183500363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MP00183500OtherLICENSE
NJ25MP00183500OtherLICENSE