Basic Information
Provider Information
NPI: 1144272030
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORRE
FirstName: JOSEPH
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6255 SHERIDAN DR
Address2: SUITE 304
City: WILLIAMSVILLE
State: NY
PostalCode: 142214836
CountryCode: US
TelephoneNumber: 7168578666
FaxNumber: 7168578944
Practice Location
Address1: 85 HIGH ST
Address2:  
City: BUFFALO
State: NY
PostalCode: 142031149
CountryCode: US
TelephoneNumber: 7168578620
FaxNumber: 7162505966
Other Information
ProviderEnumerationDate: 05/17/2006
LastUpdateDate: 03/13/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101X121131-1NYY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

ID Information
IDTypeStateIssuerDescription
00051119500101NYHEALTH NOWOTHER
002174801NYGHIOTHER
220374801NYIHAOTHER
0002050330101NYUNIVERAOTHER
0137171905NY MEDICAID


Home