Provider Demographics
NPI:1336369016
Name:GARCIA, ANGEL JR (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WALT WHITMAN RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746
Mailing Address - Country:US
Mailing Address - Phone:516-220-2334
Mailing Address - Fax:631-470-4720
Practice Address - Street 1:601 PELHAM PKWY N APT 507
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-8098
Practice Address - Country:US
Practice Address - Phone:646-242-3449
Practice Address - Fax:718-960-3683
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62015407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ01H21Medicare ID - Type Unspecified