Provider Demographics
NPI:1043501125
Name:TORIO, PURA RIZA PULIDO (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MISS
First Name:PURA RIZA
Middle Name:PULIDO
Last Name:TORIO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 JUNEGRASS WAY
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4539
Mailing Address - Country:US
Mailing Address - Phone:201-736-0856
Mailing Address - Fax:
Practice Address - Street 1:43 JUNEGRASS WAY
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4539
Practice Address - Country:US
Practice Address - Phone:201-736-0856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00587300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist