Provider Demographics
NPI:1700887270
Name:TORRE, DAWN F (MD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:F
Last Name:TORRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 FRANKLIN AVE
Mailing Address - Street 2:153
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5801
Mailing Address - Country:US
Mailing Address - Phone:516-294-1800
Mailing Address - Fax:516-746-7044
Practice Address - Street 1:520 FRANKLIN AVE
Practice Address - Street 2:153
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5801
Practice Address - Country:US
Practice Address - Phone:516-294-1800
Practice Address - Fax:516-746-7044
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183135207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01407276Medicaid
NY90F351Medicare ID - Type Unspecified
NY01407276Medicaid