Provider Demographics
NPI:1982179735
Name:GARCIA, JEREMIE VELASCO (MSN, APRN, AGNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:JEREMIE
Middle Name:VELASCO
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MSN, APRN, AGNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PETER COOPER RD APT 1F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6748
Mailing Address - Country:US
Mailing Address - Phone:347-713-2887
Mailing Address - Fax:
Practice Address - Street 1:171 DELANCEY ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3411
Practice Address - Country:US
Practice Address - Phone:929-455-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF308631-1363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care