Basic Information
| Provider Information | |||||||||
| NPI: | 1992126080 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | JEANNETTE | ||||||||
| MiddleName: | MARIA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ZIOBRO | ||||||||
| OtherFirstName: | JEANNETTE | ||||||||
| OtherMiddleName: | MARIA | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1225 WHITEHORSE MERCERVILLE RD | ||||||||
| Address2: | BLDG. D, SUITE 220 | ||||||||
| City: | MERCERVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086193882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095812200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1225 WHITEHORSE MERCERVILLE RD | ||||||||
| Address2: | BLDG. D, SUITE 220 | ||||||||
| City: | MERCERVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086193882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095812200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2013 | ||||||||
| LastUpdateDate: | 11/09/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.