Healthcare Provider Details

I. General information

NPI: 1568018232
Provider Name (Legal Business Name): HERWIN TORRES LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2019
Last Update Date: 08/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1239 PARKWAY AVE
EWING NJ
08628-3000
US

IV. Provider business mailing address

4 HIRTH DR
HAMILTON NJ
08620-2409
US

V. Phone/Fax

Practice location:
  • Phone: 609-394-5157
  • Fax:
Mailing address:
  • Phone: 732-664-5427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL05678400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: