Provider Demographics
NPI:1962761015
Name:TORRE, ANNEMARIE ROSE (OTR/L)
Entity type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:ROSE
Last Name:TORRE
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 1:217 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1847
Mailing Address - Country:US
Mailing Address - Phone:347-996-0390
Mailing Address - Fax:
Practice Address - Street 1:217 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1847
Practice Address - Country:US
Practice Address - Phone:347-996-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021382225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics