Provider Demographics
NPI:1417042235
Name:GARCIA, GILBERT CORTEZ (PT)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:CORTEZ
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1101
Mailing Address - Country:US
Mailing Address - Phone:201-344-8235
Mailing Address - Fax:201-792-5343
Practice Address - Street 1:131 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1101
Practice Address - Country:US
Practice Address - Phone:201-344-8235
Practice Address - Fax:201-792-5343
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00928300225100000X
NY022327225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ093306UG4Medicare ID - Type UnspecifiedRENDERING PHYSICIAN ID