Provider Demographics
NPI:1952521320
Name:TORRES, ROWENA VERA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROWENA VERA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 15TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2539
Mailing Address - Country:US
Mailing Address - Phone:917-445-7787
Mailing Address - Fax:
Practice Address - Street 1:20 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-2003
Practice Address - Country:US
Practice Address - Phone:631-281-1890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028016261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY028016OtherPT LICENSE NUMBER
NY3814OtherSSN LAST FOUR