Provider Demographics
NPI:1801299193
Name:GARCIA, STEPHANIES
Entity type:Individual
Prefix:
First Name:STEPHANIES
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2186 CRUGER AVE APT LD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1602
Mailing Address - Country:US
Mailing Address - Phone:347-658-8105
Mailing Address - Fax:
Practice Address - Street 1:2186 CRUGER AVE APT LD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-1602
Practice Address - Country:US
Practice Address - Phone:347-658-8105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator