Provider Demographics
NPI:1740417229
Name:TORRES, JASON MATTHEW (CSA)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:MATTHEW
Last Name:TORRES
Suffix:
Gender:M
Credentials:CSA
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 935
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23439-0935
Mailing Address - Country:US
Mailing Address - Phone:757-292-7561
Mailing Address - Fax:
Practice Address - Street 1:601 HILLPOINT BLVD
Practice Address - Street 2:# 1321
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8185
Practice Address - Country:US
Practice Address - Phone:757-292-7561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist