Provider Demographics
NPI:1376114348
Name:TORRES, NATALIE ANN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:ANN
Last Name:TORRES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 MADDEN RD
Mailing Address - Street 2:
Mailing Address - City:PANAMA
Mailing Address - State:NY
Mailing Address - Zip Code:14767-9724
Mailing Address - Country:US
Mailing Address - Phone:716-969-0330
Mailing Address - Fax:
Practice Address - Street 1:1684 FOOTE AVENUE EXT
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-9385
Practice Address - Country:US
Practice Address - Phone:716-661-9730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026749363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant