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General NPI Number Information
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NPI Number | 1407899636
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Entity Type | Individual
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Provider Name | MARY JANE B. TORRES M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 175 E BROWN ST SUITE 108
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3098
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Country | US
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Telephone | 570-476-3585
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Fax | 570-421-9014
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Provider Business Mailing Address
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Address Line | 175 E BROWN ST SUITE 108
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3098
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Country | US
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Telephone | 570-420-4951
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Fax | 570-476-3754
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 25MA07860200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD431827
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License Number State | PA
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