Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 25MB08972700 | NJ |
Y | 207Q00000X | Family Doctor | 25MB08972700 | NJ |
NPI | 1124251939 |
---|---|
Provider Name | Dr. Jonathan William Torres |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2009 |
Last Update Date | 08/06/2013 |