1316929110 NPI number — ANDREA G TORRADO MD

Table of content: ANDREA G TORRADO MD (NPI 1316929110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316929110 NPI number — ANDREA G TORRADO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRADO
Provider First Name:
ANDREA
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1316929110
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 GRAHAM RD W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ITHACA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14850-1055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-257-2188
Provider Business Mailing Address Fax Number:
607-266-7341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 GRAHAM RD W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ITHACA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14850-1055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-257-2188
Provider Business Practice Location Address Fax Number:
607-266-7341
Provider Enumeration Date:
11/17/2005

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: 208000000X , with the licence number:  223473 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000142437 . This is a "BLUE SHIELD/HMO/EXCELLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02271492 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 161010811 . This is a "COMMERCIAL CARRIERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5615598 . This is a "AETNA MANAGED CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000920079001 . This is a "HEALTHNOW" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6703 . This is a "TOTAL CARE/MANAGED MA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 161010811 . This is a "RMSCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: V018315 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".




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