Provider Demographics
NPI:1609323179
Name:GARCIA, REBECCA STANSKI (RD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:STANSKI
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870R COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1232
Mailing Address - Country:US
Mailing Address - Phone:617-278-6380
Mailing Address - Fax:617-278-6386
Practice Address - Street 1:6295 WETHEROLE ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1564
Practice Address - Country:US
Practice Address - Phone:908-797-9102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA86003174133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered