MEDICARE: PHILIP TYLER TORRES OTR

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	225X00000X	Occupational Therapist		NY

General Provider Information

NPI Number	:	1285346072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP TYLER TORRES OTR

Provider Business Mailing Address
First Line	:	36 WAVEY WILLOW LN
Second Line	:
City	:	MONTGOMERY
State	:	NY
Zip	:	12549-1501
Country	:	US
Telephone Number	:	845-741-9457
Fax Number	:

Provider Business Practice Location Address
First Line	:	1406 KINGS HIGHWAY
Second Line	:
City	:	SUGAR LOAF
State	:	NY
Zip	:	10981
Country	:	US
Telephone Number	:	845-827-5360
Fax Number	:

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

Provider Enumeration Date	:	12/23/2022
Last Update Date	:	12/23/2022

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