Provider Demographics
NPI:1083326813
Name:NAZARIO-TORRES, LORRAINE RAGUDO (PT)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:RAGUDO
Last Name:NAZARIO-TORRES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 KELLOGG CT
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-4315
Mailing Address - Country:US
Mailing Address - Phone:201-660-3718
Mailing Address - Fax:
Practice Address - Street 1:2989 MAIN ST
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:NY
Practice Address - Zip Code:12972-2927
Practice Address - Country:US
Practice Address - Phone:518-643-2740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039146-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty