Basic Information
Provider Information
NPI: 1134391899
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORGERSON
FirstName: SARA
MiddleName: REBECCA
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2550 UNIVERSITY AVE W
Address2: SUITE 110 N
City: SAINT PAUL
State: MN
PostalCode: 551141052
CountryCode: US
TelephoneNumber: 6516025311
FaxNumber: 6512226786
Practice Location
Address1: 345 SHERMAN ST
Address2: SUITE 100
City: SAINT PAUL
State: MN
PostalCode: 551022401
CountryCode: US
TelephoneNumber: 6512515500
FaxNumber: 6512515555
Other Information
ProviderEnumerationDate: 04/01/2008
LastUpdateDate: 11/13/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X58695MNY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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