Provider Demographics
NPI:1437900131
Name:TORRENCE, COREY A (PA-C)
Entity type:Individual
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First Name:COREY
Middle Name:A
Last Name:TORRENCE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2642
Mailing Address - Country:US
Mailing Address - Phone:617-414-5405
Mailing Address - Fax:617-414-6031
Practice Address - Street 1:830 HARRISON AVENUE
Practice Address - Street 2:STE 1400
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8124
Practice Address - Fax:617-414-4953
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-09-06
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Provider Licenses
StateLicense IDTaxonomies
MAPA100647363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant