Provider Demographics
NPI:1518118199
Name:GARCIA, CARLOS JOEL (CRNP)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:JOEL
Last Name:GARCIA
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
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Mailing Address - Street 1:225 ERDMAN ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-2043
Mailing Address - Country:US
Mailing Address - Phone:610-588-2225
Mailing Address - Fax:610-588-2292
Practice Address - Street 1:101 POCONO CMNS STE 101
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-7599
Practice Address - Country:US
Practice Address - Phone:570-872-9955
Practice Address - Fax:570-872-9288
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP013710363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner