Healthcare Provider Details

I. General information

NPI: 1154425791
Provider Name (Legal Business Name): JOSE BERNARDO TORO M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 11/27/2023
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 E MAIN ST
MIDDLETOWN NY
10940-2650
US

IV. Provider business mailing address

707 E MAIN ST
MIDDLETOWN NY
10940-2650
US

V. Phone/Fax

Practice location:
  • Phone: 845-333-7575
  • Fax: 845-333-7201
Mailing address:
  • Phone: 845-333-7575
  • Fax: 845-333-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number61002495
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: