Provider Demographics
NPI:1356646061
Name:GARCIA, ANGELA LUCIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LUCIA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 2ND ST APT 610
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4902
Mailing Address - Country:US
Mailing Address - Phone:347-996-7297
Mailing Address - Fax:
Practice Address - Street 1:1 2ND ST APT 610
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4902
Practice Address - Country:US
Practice Address - Phone:347-996-7297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020631235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist