Provider Demographics
NPI:1437307816
Name:GARCIA, ANTHONY GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:GERARD
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 BROADWAY
Mailing Address - Street 2:STE. A
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2742
Mailing Address - Country:US
Mailing Address - Phone:631-264-2424
Mailing Address - Fax:631-264-7881
Practice Address - Street 1:137 BROADWAY
Practice Address - Street 2:STE. A
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2742
Practice Address - Country:US
Practice Address - Phone:631-264-2424
Practice Address - Fax:631-264-7881
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229578207R00000X
TXN3659207R00000X, 208M00000X
NY269609-1207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207797601Medicaid
TX1437307816Medicare PIN
TX207797601Medicaid
TXP00783867Medicare PIN