Provider Demographics
NPI:1457490427
Name:GARCIA, GRACIA JALANDONI (MD)
Entity Type:Individual
Prefix:MISS
First Name:GRACIA
Middle Name:JALANDONI
Last Name:GARCIA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:19 BELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3712
Mailing Address - Country:US
Mailing Address - Phone:516-746-3998
Mailing Address - Fax:
Practice Address - Street 1:998 CROOKED HILL RD
Practice Address - Street 2:PILGRIM PSYCHIATRIC CENTER,BLDG . 25
Practice Address - City:WEST BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1043
Practice Address - Country:US
Practice Address - Phone:631-761-3500
Practice Address - Fax:631-761-3599
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY131844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO8390Medicare UPIN