Provider Demographics
NPI:1952662801
Name:TORRENTE, JUSTIN (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:TORRENTE
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:PO BOX 746087
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6087
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:1114 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-2922
Practice Address - Country:US
Practice Address - Phone:718-765-6058
Practice Address - Fax:478-084-8953
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201229390200000X
NY278863207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY00695941Medicaid
NY331943Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331954Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331947Medicare Oscar/Certification