Provider Demographics
NPI:1770758799
Name:ANGEL GARCIA JR, DPT
Entity type:Organization
Organization Name:ANGEL GARCIA JR, DPT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-242-3449
Mailing Address - Street 1:601 PELHAM PKWY N
Mailing Address - Street 2:APT 507
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8011
Mailing Address - Country:US
Mailing Address - Phone:646-242-3449
Mailing Address - Fax:631-470-4721
Practice Address - Street 1:33 WALT WHITMAN RD
Practice Address - Street 2:SUITE 240
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3640
Practice Address - Country:US
Practice Address - Phone:646-242-3449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ01H21Medicare PIN