Basic Information
Provider Information
NPI: 1831509231
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORRES
FirstName: MILAGROS
MiddleName: MERCADO
NamePrefix: MS.
NameSuffix:  
Credential: SPECIAL EDUCATION TE
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7000 AUSTIN STREET
Address2: SUITE 200
City: FOREST HILLS
State: NY
PostalCode: 11375
CountryCode: US
TelephoneNumber: 7187627633
FaxNumber: 7188868694
Practice Location
Address1: 7000 AUSTIN STREET
Address2: SUITE 200
City: FOREST HILLS
State: NY
PostalCode: 11375
CountryCode: US
TelephoneNumber: 7187627633
FaxNumber: 7188868694
Other Information
ProviderEnumerationDate: 05/07/2014
LastUpdateDate: 05/07/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X  Y Other Service ProvidersSpecialist 

No ID Information.


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