Healthcare Provider Details

I. General information

NPI: 1932163870
Provider Name (Legal Business Name): NESTOR ENRIQUE TORRES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ENRIQUE TORRES MD

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 MAIN ST
WILLIMANTIC CT
06226-1948
US

IV. Provider business mailing address

84 WALNUT ST
WILLIMANTIC CT
06226-2328
US

V. Phone/Fax

Practice location:
  • Phone: 860-450-7471
  • Fax:
Mailing address:
  • Phone: 860-456-8806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number038270
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number038270
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: