Provider Demographics
NPI:1528220811
Name:GARCIA, JOANNE HAZEL
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:HAZEL
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JOANNE
Other - Middle Name:HAZEL
Other - Last Name:JUDAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPA-C
Mailing Address - Street 1:85-51 150TH STREET
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 E 68TH STREET
Practice Address - Street 2:NEW YORK PRESBYTERIAN - WEIL CORNELL MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:212-746-4935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009717363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY160988442OtherNPI