Healthcare Provider Details

I. General information

NPI: 1790794899
Provider Name (Legal Business Name): JOSEPH MICHAEL TOROK JR. RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

2753 WILLIAMSBURG BANTAM RD
BETHEL OH
45106-9380
US

V. Phone/Fax

Practice location:
  • Phone: 513-872-2697
  • Fax:
Mailing address:
  • Phone: 513-734-0396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN221302
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: