Provider Demographics
NPI:1710348925
Name:TORRES, GIRLIE GRACE ZALDARRIAGA
Entity Type:Individual
Prefix:MISS
First Name:GIRLIE GRACE
Middle Name:ZALDARRIAGA
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8805 53RD AVE
Mailing Address - Street 2:ELMHURST
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4517
Mailing Address - Country:US
Mailing Address - Phone:929-353-8122
Mailing Address - Fax:
Practice Address - Street 1:8805 53RD AVE
Practice Address - Street 2:ELMHURST
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4517
Practice Address - Country:US
Practice Address - Phone:929-353-8122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019388-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist