Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | F320088 | NY |
NPI | 1053715243 |
---|---|
Provider Name | Edwin A Torres |
First Address | New York, NY 10031 |
Second Address | New York, NY 10031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2014 |
Last Update Date | 16/10/2014 |