Provider Demographics
NPI:1639514946
Name:DEBORRA M. TORRES, MSN PMHNP LLC
Entity Type:Organization
Organization Name:DEBORRA M. TORRES, MSN PMHNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MSN PMHNP
Authorized Official - Phone:609-500-4018
Mailing Address - Street 1:4 FLAGSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SHAMONG
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-8532
Mailing Address - Country:US
Mailing Address - Phone:609-500-4018
Mailing Address - Fax:973-857-2972
Practice Address - Street 1:5 N MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2439
Practice Address - Country:US
Practice Address - Phone:609-500-4018
Practice Address - Fax:973-857-2972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR06248100103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty