1679514723 NPI number — JASON A TORRENTE DO

Table of content: JASON A TORRENTE DO (NPI 1679514723)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679514723 NPI number — JASON A TORRENTE DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRENTE
Provider First Name:
JASON
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

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:
1679514723
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26 STONEHAM DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELRAN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08075-1346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-209-2938
Provider Business Mailing Address Fax Number:
888-572-0094

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 FIRST RESPONDERS WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08691-1904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-249-7073
Provider Business Practice Location Address Fax Number:
609-249-7074
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MB073083 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 118141223 . This is a "DEPARTMENT OF LABOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1863591 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 102538360001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2721770000 . This is a "KEYSTONE IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6504869 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com