Provider Demographics
NPI:1609875327
Name:TORRES, CRISANTO M (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISANTO
Middle Name:M
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 ATRIUM DR
Mailing Address - Street 2:SUITE 100 ATTN: TAMMY M. BUTTON
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1441
Mailing Address - Country:US
Mailing Address - Phone:518-435-2740
Mailing Address - Fax:518-458-2610
Practice Address - Street 1:425 GUY PARK AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-1043
Practice Address - Country:US
Practice Address - Phone:518-842-3330
Practice Address - Fax:518-845-5931
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY113849207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00547993Medicaid
NYC49682Medicare UPIN
NYRA2989Medicare ID - Type Unspecified