Provider Demographics
NPI:1639906522
Name:TORRES HENRIQUEZ, JONATHAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:TORRES HENRIQUEZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JONATHAN
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:29 WASHINGTON ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-4221
Mailing Address - Country:US
Mailing Address - Phone:914-966-9647
Mailing Address - Fax:
Practice Address - Street 1:81 S BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4004
Practice Address - Country:US
Practice Address - Phone:914-375-3306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052804225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist