MEDICARE: JUANA TORRES

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	225700000X	Massage Therapist	18KT00139300	NJ

General Provider Information

NPI Number	:	1336544600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUANA TORRES

Provider Business Mailing Address
First Line	:	136 42ND ST
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-6177
Country	:	US
Telephone Number	:	551-221-4481
Fax Number	:

Provider Business Practice Location Address
First Line	:	4205 PARK AVENUE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-6177
Country	:	US
Telephone Number	:	551-221-4481
Fax Number	:

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

Provider Enumeration Date	:	10/29/2014
Last Update Date	:	10/29/2014

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Directions to “ JUANA TORRES ” Practice Location

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