Provider Demographics
NPI:1275690190
Name:TORRES, RUBEN (CLSW)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:CLSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 215TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1727
Mailing Address - Country:US
Mailing Address - Phone:718-631-4864
Mailing Address - Fax:
Practice Address - Street 1:502 PUGSLEY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-1820
Practice Address - Country:US
Practice Address - Phone:718-631-4864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR051032-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker