1003859265 NPI number — EFRAIN A TORRES M.D.

Table of content: EFRAIN A TORRES M.D. (NPI 1003859265)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003859265 NPI number — EFRAIN A TORRES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRES
Provider First Name:
EFRAIN
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NAVARRO
Provider Other First Name:
EFRAIN
Provider Other Middle Name:
ALEJANDRO TORRES
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1003859265
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
54 BRIGHAM ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BEDFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02740-2208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-979-1100
Provider Business Mailing Address Fax Number:
508-979-1918

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
54 BRIGHAM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02740-2208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-979-1100
Provider Business Practice Location Address Fax Number:
508-979-1918
Provider Enumeration Date:
06/14/2006

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: 207RG0300X , with the licence number:  210494 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 20012020 . This is a "AMERIHEALTH MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2263550000 . This is a "AMERIHEALTH 65" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: T01584790 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P003208 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000124194 . This is a "UNISON HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1858813 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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