Provider Demographics
NPI:1407007446
Name:TORRES-JIMENEZ, PEDRO (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:
Last Name:TORRES-JIMENEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W 101ST ST
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5045
Mailing Address - Country:US
Mailing Address - Phone:212-749-4400
Mailing Address - Fax:
Practice Address - Street 1:215 W 101ST ST
Practice Address - Street 2:SUITE 1-A
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10025-5045
Practice Address - Country:US
Practice Address - Phone:212-749-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177157207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01115360Medicaid
NY01115360Medicaid
F42555Medicare PIN