Healthcare Provider Details

I. General information

NPI: 1659820249
Provider Name (Legal Business Name): SARA TORRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2016
Last Update Date: 09/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE
FARMINGTON CT
06032-1956
US

IV. Provider business mailing address

5 ESSEX LN
WOODBURY CT
06798-2631
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-2000
  • Fax:
Mailing address:
  • Phone: 203-215-3341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number002821
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: