Provider Demographics
NPI:1689882037
Name:TORRES, ELENA LISA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:LISA
Last Name:TORRES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GREY WOLF DR
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1463
Mailing Address - Country:US
Mailing Address - Phone:585-349-1896
Mailing Address - Fax:585-349-1896
Practice Address - Street 1:8 GREY WOLF DR
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1463
Practice Address - Country:US
Practice Address - Phone:585-349-1896
Practice Address - Fax:585-349-1896
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234869-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01880717Medicaid