Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 001155 |
NPI | 1083839831 |
---|---|
Provider Name | Diana Torres |
First Address | Brooklyn, NY 11211-6307 |
Second Address | Jamaica, NY 11432-2904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 17/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00695941 | (05) | NY |