Provider Demographics
NPI:1760228803
Name:TORRES, STEPHANY MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:MARIE
Last Name:TORRES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1001
Mailing Address - Country:US
Mailing Address - Phone:201-926-0442
Mailing Address - Fax:
Practice Address - Street 1:1373 BROAD ST STE 204
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-4231
Practice Address - Country:US
Practice Address - Phone:862-378-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01183700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist