Provider Demographics
NPI:1407899636
Name:TORRES, MARY JANE B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY JANE
Middle Name:B
Last Name:TORRES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:175 E BROWN ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3098
Mailing Address - Country:US
Mailing Address - Phone:570-420-4951
Mailing Address - Fax:570-476-3754
Practice Address - Street 1:175 E BROWN ST
Practice Address - Street 2:SUITE 108
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-3098
Practice Address - Country:US
Practice Address - Phone:570-476-3585
Practice Address - Fax:570-421-9014
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2012-02-29
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07860200173000000X
PAMD431827208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020224200001Medicaid