Provider Demographics
NPI:1447587183
Name:GARCIA, DIANA (PEDIATRIC RN)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PEDIATRIC RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HERITAGE DR APT K
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5350
Mailing Address - Country:US
Mailing Address - Phone:845-323-4344
Mailing Address - Fax:
Practice Address - Street 1:22 HERITAGE DR APT K
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5350
Practice Address - Country:US
Practice Address - Phone:845-323-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232356163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics