Healthcare Provider Details

I. General information

NPI: 1548920044
Provider Name (Legal Business Name): KRISTIN ANN TORRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2021
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 KINGS HWY
BROOKLYN NY
11234-2625
US

IV. Provider business mailing address

11 TALL TREE RD
MIDDLETOWN NJ
07748-2925
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-8900
  • Fax: 212-844-8901
Mailing address:
  • Phone: 732-882-9373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number02989001
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: