Provider Demographics
NPI:1265755946
Name:GARCIA, EDWARD MANUEL II (LPN)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:MANUEL
Last Name:GARCIA
Suffix:II
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 CORAM MOUNT SINAI RD
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727
Mailing Address - Country:US
Mailing Address - Phone:631-880-7467
Mailing Address - Fax:
Practice Address - Street 1:39 MOUNT SINAI CORAM RD
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-3054
Practice Address - Country:US
Practice Address - Phone:631-880-7467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295228164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse