Healthcare Provider Details

I. General information

NPI: 1194838730
Provider Name (Legal Business Name): LUIS A TORO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 06/22/2020
Certification Date: 06/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 RIDGE RD
LANCASTER PA
17603-4737
US

IV. Provider business mailing address

1529 RIDGE RD
LANCASTER PA
17603-4737
US

V. Phone/Fax

Practice location:
  • Phone: 717-814-2555
  • Fax:
Mailing address:
  • Phone: 717-814-2555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD449969
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: