Provider Demographics
NPI:1023490695
Name:TORRES, WILBERTO
Entity type:Individual
Prefix:
First Name:WILBERTO
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 DUBLIN AVE
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-2044
Mailing Address - Country:US
Mailing Address - Phone:603-233-8457
Mailing Address - Fax:
Practice Address - Street 1:5 PINE STREET EXT
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3248
Practice Address - Country:US
Practice Address - Phone:603-821-7421
Practice Address - Fax:603-821-7474
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH372600000X
NH04094374U00000X, 376J00000X, 372600000X, 164W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No164W00000XNursing Service ProvidersLicensed Practical Nurse