Provider Demographics
NPI:1255857199
Name:TORRES-PAGAN, LEONELL (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEONELL
Middle Name:
Last Name:TORRES-PAGAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 PACIFIC ST APT 6E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3923
Mailing Address - Country:US
Mailing Address - Phone:347-600-3171
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE RM 1213
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6693
Practice Address - Country:US
Practice Address - Phone:917-705-6155
Practice Address - Fax:212-252-8808
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022221103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical