Provider Demographics
NPI:1629016829
Name:TORRES REYES, NEISA M (MD)
Entity Type:Individual
Prefix:DR
First Name:NEISA
Middle Name:M
Last Name:TORRES REYES
Suffix:
Gender:F
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:PO BOX 6897
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-5897
Mailing Address - Country:US
Mailing Address - Phone:787-485-9739
Mailing Address - Fax:787-779-5297
Practice Address - Street 1:64 CALLE SANTA CRUZ
Practice Address - Street 2:EDIF GALERIA MEDICA SUITE 201
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7003
Practice Address - Country:US
Practice Address - Phone:787-778-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12767174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89964Medicare ID - Type UnspecifiedNUMERO PROVEEDOR
PRG97367Medicare UPIN