=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578674545
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GARY TORBEY DO PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 10/14/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27 HOSPITAL DRIVE
-----------------------------------------------------
City | MASSENA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13662-1009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-769-2484
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27 HOSPITAL DRIVE
-----------------------------------------------------
City | MASSENA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13662-1009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-769-2484
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | GARY TORBEY
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 315-769-2484
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 208237
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------