Provider Demographics
NPI:1881648798
Name:TORRE, DARIO M (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIO
Middle Name:M
Last Name:TORRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1321
Mailing Address - Country:US
Mailing Address - Phone:215-762-5188
Mailing Address - Fax:215-399-5896
Practice Address - Street 1:219 N BROAD ST
Practice Address - Street 2:6TH FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1519
Practice Address - Country:US
Practice Address - Phone:215-762-5188
Practice Address - Fax:215-399-5896
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44582207R00000X
PAMD062628L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34205200Medicaid
006000261VOtherHUMANA
006000261VOtherHUMANA
G54217Medicare UPIN