Provider Demographics
NPI:1740439900
Name:GARCIA, RACHEL (FNP-BC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANNE
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:129 W 29TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5105
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:
Practice Address - Street 1:1790 BROADWAY
Practice Address - Street 2:SUITE 1802
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1412
Practice Address - Country:US
Practice Address - Phone:415-658-6791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167999363LF0000X
NY338289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA142804ZCCUMedicare PIN
VAMC11907Medicare PIN