Provider Demographics
NPI:1730253667
Name:TORRUELLA, ISAAC ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:ANTONIO
Last Name:TORRUELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MONTCLAIR RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2831
Mailing Address - Country:US
Mailing Address - Phone:914-377-0493
Mailing Address - Fax:
Practice Address - Street 1:125 CORPORATE BLVD # 307
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-6840
Practice Address - Country:US
Practice Address - Phone:914-377-0493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2154292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
81M411Medicare ID - Type Unspecified