Basic Information
Provider Information
NPI: 1740508191
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARCIA-MEDINA
FirstName: LYMARIS
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8 STRAUB DR
Address2:  
City: PLEASANT VALLEY
State: NY
PostalCode: 125695307
CountryCode: US
TelephoneNumber: 8457076936
FaxNumber:  
Practice Location
Address1: 71 PROSPECT AVE
Address2:  
City: HUDSON
State: NY
PostalCode: 125342907
CountryCode: US
TelephoneNumber: 5186977823
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/10/2010
LastUpdateDate: 08/14/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X256969NYY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200X256969NYN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


Home