1326092586 NPI number — BRIAN R TORCATO MD PC

Table of content: (NPI 1326092586)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326092586 NPI number — BRIAN R TORCATO MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIAN R TORCATO MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326092586
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
119 BLACK WALNUT LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH MEETING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19462-1948
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-567-3857
Provider Business Mailing Address Fax Number:
215-722-8022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5900 RISING SUN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19120-1117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-722-2022
Provider Business Practice Location Address Fax Number:
215-722-8022
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TORCATO
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
215-722-2022

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  MD059220L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01603171 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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