Provider Demographics
NPI:1780303107
Name:TORGAN, LAWRENCE JOHN (DPT)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JOHN
Last Name:TORGAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 E 5TH ST APT 2K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2847
Mailing Address - Country:US
Mailing Address - Phone:347-756-8239
Mailing Address - Fax:
Practice Address - Street 1:2148 OCEAN AVE STE 301
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1486
Practice Address - Country:US
Practice Address - Phone:718-872-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty