Provider Demographics
NPI:1063623890
Name:TORO-ECHAGUE CORPORATION
Entity type:Organization
Organization Name:TORO-ECHAGUE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TORO-ECHAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-709-1212
Mailing Address - Street 1:45 SOUTH AVE W
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2686
Mailing Address - Country:US
Mailing Address - Phone:908-709-1212
Mailing Address - Fax:908-709-3711
Practice Address - Street 1:45 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2686
Practice Address - Country:US
Practice Address - Phone:908-709-1212
Practice Address - Fax:908-709-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0683701Medicaid
NJ0683701Medicaid
NJC54747Medicare UPIN