Provider Demographics
NPI:1275793432
Name:BIRCH, TORREY BOLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:TORREY
Middle Name:BOLAND
Last Name:BIRCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TORREY
Other - Middle Name:ANN
Other - Last Name:BOLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:117 ELLENFIELD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4541
Mailing Address - Country:US
Mailing Address - Phone:401-444-6779
Mailing Address - Fax:401-444-6912
Practice Address - Street 1:593 EDDY STREET APC 7 NICU
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903
Practice Address - Country:US
Practice Address - Phone:401-444-2734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1323192084A2900X, 2084A2900X
IL036.1323192084N0400X, 2084N0400X
RIMD190992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology