MEDICARE: JOSETTE MARIE TORMOS PHYSICIAN ASSISTANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA066859	PA
2	363A00000X	Physician Assistant	25MP00825700	NJ

General Provider Information

NPI Number	:	1225746860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSETTE MARIE TORMOS PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	1840 SOUTH STREET
Second Line	:	3RD FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-7411
Country	:	US
Telephone Number	:	215-829-6670
Fax Number	:	215-893-7011

Provider Business Practice Location Address
First Line	:	1840 SOUTH STREET
Second Line	:	3RD FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-7411
Country	:	US
Telephone Number	:	215-829-6670
Fax Number	:	215-893-7011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	01/06/2026

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