Basic Information
| Provider Information | |||||||||
| NPI: | 1710466842 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARCES | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17 DAVIS RD | ||||||||
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| City: | SPARTA | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078713302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9173791963 | ||||||||
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| Practice Location | |||||||||
| Address1: | 610 VALLEY HEALTH PLZ | ||||||||
| Address2: | |||||||||
| City: | PARAMUS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076523607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2012658200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2018 | ||||||||
| LastUpdateDate: | 08/09/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 26NR19061100 | NJ | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.