Provider Demographics
NPI:1467621730
Name:TORRES, ROSARIA (PAC)
Entity Type:Individual
Prefix:
First Name:ROSARIA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 LANSDOWNE AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023
Mailing Address - Country:US
Mailing Address - Phone:610-534-6270
Mailing Address - Fax:610-534-6269
Practice Address - Street 1:1501 LANSDOWNE AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023
Practice Address - Country:US
Practice Address - Phone:610-534-6270
Practice Address - Fax:610-534-6269
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003N25-L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP86268Medicare UPIN
PA068813Medicare PIN