Provider Demographics
NPI:1174359103
Name:JOSUE C TORRES
Entity type:Organization
Organization Name:JOSUE C TORRES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSUE
Authorized Official - Middle Name:C
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-500-0121
Mailing Address - Street 1:2102 BEVERLEY RD APT 2A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3930
Mailing Address - Country:US
Mailing Address - Phone:347-260-5608
Mailing Address - Fax:
Practice Address - Street 1:2102 BEVERLEY RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3969
Practice Address - Country:US
Practice Address - Phone:347-260-5608
Practice Address - Fax:718-425-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care