Provider Demographics
NPI:1992867626
Name:GARCIA, JUANAELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:JUANAELENA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PENN PLZ E
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-2258
Mailing Address - Country:US
Mailing Address - Phone:973-364-2152
Mailing Address - Fax:973-364-2020
Practice Address - Street 1:3 PENN PLZ E
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2258
Practice Address - Country:US
Practice Address - Phone:973-364-2152
Practice Address - Fax:973-364-2020
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2140622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry