Provider Demographics
NPI:1184338105
Name:GARCIA, CEDRICK JAMES LIM (PA-C)
Entity type:Individual
Prefix:
First Name:CEDRICK JAMES
Middle Name:LIM
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:3261 W STATE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT BONAVENTURE
Mailing Address - State:NY
Mailing Address - Zip Code:14778-9800
Mailing Address - Country:US
Mailing Address - Phone:856-796-2118
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON ROAD
Practice Address - Street 2:SUITE 5A43
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-623-0188
Practice Address - Fax:302-733-5640
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2024-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC5-0012116363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant