Provider Demographics
NPI:1770917908
Name:GARCIA, ENRIQUE (DPT)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:31 NEW DORP LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2351
Mailing Address - Country:US
Mailing Address - Phone:718-844-5350
Mailing Address - Fax:718-390-0067
Practice Address - Street 1:9920 4TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-8333
Practice Address - Country:US
Practice Address - Phone:718-844-5350
Practice Address - Fax:718-390-0067
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY036451-1208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation