Provider Demographics
NPI:1760075899
Name:TORRES, JOSE MIGUEL
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:MIGUEL
Last Name:TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STONY BROOK MEDICINE DEPARTMENT OF UROLOGY HSC T-9 ROOM
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8093
Mailing Address - Country:US
Mailing Address - Phone:631-444-6270
Mailing Address - Fax:631-444-3765
Practice Address - Street 1:STONY BROOK MEDICINE DEPARTMENT OF UROLOGY HSC T-9 ROOM
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8093
Practice Address - Country:US
Practice Address - Phone:631-444-6270
Practice Address - Fax:631-444-3765
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program