Provider Demographics
NPI:1932163870
Name:TORRES, NESTOR ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:NESTOR
Middle Name:ENRIQUE
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ENRIQUE
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:84 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-2328
Mailing Address - Country:US
Mailing Address - Phone:860-456-8806
Mailing Address - Fax:
Practice Address - Street 1:1315 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-1948
Practice Address - Country:US
Practice Address - Phone:860-450-7471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038270207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT766871Medicaid
CT001001990Medicaid
038270OtherCONNECTICARE
CT080001409OtherMEDICARE PIN (GENERATIONS)
CT5754991OtherCIGNA
CT010038270CT02OtherBCBS
7497187OtherAETNA
CT001001990Medicaid
CT766871Medicaid