Provider Demographics
NPI:1518024439
Name:GARCIA, JULIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 MORICHES MIDDLE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-2113
Mailing Address - Country:US
Mailing Address - Phone:631-874-0356
Mailing Address - Fax:631-874-0453
Practice Address - Street 1:472 MORICHES MIDDLE ISLAND RD
Practice Address - Street 2:
Practice Address - City:MANORVILLE
Practice Address - State:NY
Practice Address - Zip Code:11949-2113
Practice Address - Country:US
Practice Address - Phone:631-874-0356
Practice Address - Fax:631-874-0453
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY481945163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01667376Medicaid