Provider Demographics
NPI:1700887072
Name:GARCIA, HORTENCIA CECILIA (MD)
Entity Type:Individual
Prefix:
First Name:HORTENCIA
Middle Name:CECILIA
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 1:23405 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2707
Mailing Address - Country:US
Mailing Address - Phone:718-347-3240
Mailing Address - Fax:
Practice Address - Street 1:1865 HONE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1406
Practice Address - Country:US
Practice Address - Phone:718-823-9543
Practice Address - Fax:718-823-5757
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197478207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01592929Medicaid
NYF91891Medicare UPIN
NY65J621Medicare ID - Type Unspecified