Provider Demographics
NPI:1578005799
Name:IRIZARRY GARCIA, CHRISTY MARIE (PSY D)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:MARIE
Last Name:IRIZARRY GARCIA
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2279 PONCE BY PASS
Mailing Address - Street 2:CARIBBEAN MEDICAL CENTER EDIF ANEXO
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1379
Mailing Address - Country:US
Mailing Address - Phone:787-671-8914
Mailing Address - Fax:
Practice Address - Street 1:2279 PONCE BY PASS
Practice Address - Street 2:CARIBBEAN MEDICAL CENTER EDIF ANEXO
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1379
Practice Address - Country:US
Practice Address - Phone:787-409-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005749103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5749OtherPHD LIC.
PR5749OtherPHD LIC.