Healthcare Provider Details

I. General information

NPI: 1548645807
Provider Name (Legal Business Name): SANDRA FABIOLA TORRES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 01/26/2025
Certification Date: 01/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1253 DEER PARK AVE
NORTH BABYLON NY
11703-3104
US

IV. Provider business mailing address

256 SEQUAMS LANE CTR
WEST ISLIP NY
11795-4530
US

V. Phone/Fax

Practice location:
  • Phone: 631-258-8110
  • Fax:
Mailing address:
  • Phone: 631-258-8110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number701380
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberF355813
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: