Healthcare Provider Details

I. General information

NPI: 1659669661
Provider Name (Legal Business Name): DAVID BRIAN TORRALES O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6438 BASILE ROWE
EAST SYRACUSE NY
13057-3900
US

IV. Provider business mailing address

8494 VAN WIE DR W
BALDWINSVILLE NY
13027-8935
US

V. Phone/Fax

Practice location:
  • Phone: 315-434-9168
  • Fax: 315-434-9182
Mailing address:
  • Phone: 318-885-0764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number007712
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number007712
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number007712
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number007712
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number007712
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: