Provider Demographics
NPI:1326092586
Name:BRIAN R TORCATO MD PC
Entity Type:Organization
Organization Name:BRIAN R TORCATO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:TORCATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-722-2022
Mailing Address - Street 1:119 BLACK WALNUT LN
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1948
Mailing Address - Country:US
Mailing Address - Phone:610-567-3857
Mailing Address - Fax:215-722-8022
Practice Address - Street 1:5900 RISING SUN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-1117
Practice Address - Country:US
Practice Address - Phone:215-722-2022
Practice Address - Fax:215-722-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059220L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01603171Medicaid
G35589Medicare UPIN
TO892925Medicare ID - Type Unspecified