Healthcare Provider Details

I. General information

NPI: 1023490695
Provider Name (Legal Business Name): WILBERTO TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 09/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PINE STREET EXT
NASHUA NH
03060-3248
US

IV. Provider business mailing address

60 DUBLIN AVE
NASHUA NH
03063-2044
US

V. Phone/Fax

Practice location:
  • Phone: 603-821-7421
  • Fax: 603-821-7474
Mailing address:
  • Phone: 603-233-8457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: