Provider Demographics
NPI:1114161684
Name:TORRES, JOSE LUIS (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:LUIS
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:530 1ST AVE
Mailing Address - Street 2:HCC 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:646-501-0252
Mailing Address - Fax:646-754-9778
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:HCC 5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:646-501-0252
Practice Address - Fax:646-754-9778
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2021-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY273418-12084V0102X
PAMT194801390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology