Provider Demographics
NPI:1326250366
Name:DELA TORRE, IRENE GAN (CNM)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:GAN
Last Name:DELA TORRE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 AVE ISLA VERDE APT 503
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-5222
Mailing Address - Country:US
Mailing Address - Phone:787-366-4800
Mailing Address - Fax:787-281-7355
Practice Address - Street 1:4429 AVE ISLA VERDE APT 503
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-5222
Practice Address - Country:US
Practice Address - Phone:787-366-4800
Practice Address - Fax:787-281-7355
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR683367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife