Provider Demographics
NPI:1043922875
Name:VERDECIA GARCIA, LLAIMARYS HILDA
Entity type:Individual
Prefix:
First Name:LLAIMARYS
Middle Name:HILDA
Last Name:VERDECIA GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LLAIMARYS
Other - Middle Name:HILDA
Other - Last Name:VERDECIA GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:240 SOUTH 40TH ST OFFICE OF CLINICAL AFFAIRS-S6A EVANS
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-573-2588
Mailing Address - Fax:
Practice Address - Street 1:240 S 40TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-6030
Practice Address - Country:US
Practice Address - Phone:215-573-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program