Provider Demographics
NPI:1043320914
Name:TORRES, CARLOS MANUEL SR (LPN)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:MANUEL
Last Name:TORRES
Suffix:SR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 VALLEY VIEW LANE
Mailing Address - Street 2:APT. 24
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754
Mailing Address - Country:US
Mailing Address - Phone:845-292-2868
Mailing Address - Fax:
Practice Address - Street 1:7 PARKSVILLE ROAD
Practice Address - Street 2:
Practice Address - City:PARKS VILLE
Practice Address - State:NY
Practice Address - Zip Code:12768
Practice Address - Country:US
Practice Address - Phone:845-292-3296
Practice Address - Fax:845-292-7330
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280126Y164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse