Healthcare Provider Details

I. General information

NPI: 1508790783
Provider Name (Legal Business Name): JORDAN TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 CROWN ST
BROOKLYN NY
11213-5423
US

IV. Provider business mailing address

626 SUTTER AVE APT 2N
BROOKLYN NY
11207-4193
US

V. Phone/Fax

Practice location:
  • Phone: 718-363-0100
  • Fax: 718-363-3005
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number127450-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: