Basic Information
| Provider Information | |||||||||
| NPI: | 1174951982 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | CLARITZA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 215 MOUNT HOPE PL APT 1B | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104575409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124448851 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20 SICKLES AVE | ||||||||
| Address2: | |||||||||
| City: | NEW ROCHELLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 108014030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146321374 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2013 | ||||||||
| LastUpdateDate: | 08/18/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 307493 | NY | N | Nursing Service Providers | Licensed Practical Nurse | 163WA0400X | 685307 | NY | Y | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) |
No ID Information.