Provider Demographics
NPI:1972987519
Name:GARCIA-BALL, MARIA RAQUEL (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:RAQUEL
Last Name:GARCIA-BALL
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 1:306 W 48TH ST APT 9B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-1383
Mailing Address - Country:US
Mailing Address - Phone:510-277-2926
Mailing Address - Fax:
Practice Address - Street 1:306 W 48TH ST APT 9B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-1383
Practice Address - Country:US
Practice Address - Phone:510-277-2926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY686615-1163W00000X
NY340346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse