Active NPI
Estella Garcia
- Licensed Practical Nurse
- Penn Yan, NY
National Provider Identifier
1255889671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 308612
- Practice address
- 112 Kimball Ave
Penn Yan, NY 14527-1816 - Phone
- (315) 536-2752
- Fax
- (315) 536-4005
- NPI assigned
- Sep 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 308612 | NY | Primary |
Addresses
Primary practice location
112 Kimball Ave
Penn Yan, NY 14527-1816
Mailing address
14 Maiden LN
PO Box 423
Penn Yan, NY 14527-1208
Phone (315) 531-9102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 308612 | Other | NY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 308612 | NY | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473811200000",
"number": "1255889671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 MAIDEN LN",
"address_2": "PO BOX 423",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145271208",
"telephone_number": "315-531-9102",
"fax_number": "315-531-9103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 KIMBALL AVE",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145271816",
"telephone_number": "315-536-2752",
"fax_number": "315-536-4005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "ESTELLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-14",
"last_updated": "2016-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "308612",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "308612",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Penn Yan, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.