Provider Demographics
NPI:1477662203
Name:GARCIA, JOAQUIN J (PA-C)
Entity Type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:J
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 NOLL DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603
Mailing Address - Country:US
Mailing Address - Phone:717-299-8933
Mailing Address - Fax:717-299-5635
Practice Address - Street 1:2150 NOLL DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603
Practice Address - Country:US
Practice Address - Phone:717-299-8933
Practice Address - Fax:717-299-5635
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA003624L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical