Detorres, Wayne Raymond
Detorres, Wayne Raymond is an individual health care provider with primary practice located at 4 Godwin Avenue , Midland Park NJ 07432. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Detorres, Wayne Raymond can be contacted via phone (201) 444-7070.Contact Information
Primary practice address
4 Godwin Avenue
Midland Park NJ 07432
Phone: (201) 444-7070
Fax: (201) 444-7228
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MA70238 | New Jersey |
Profile Details
| NPI number | 1811039357 |
|---|---|
| LBN Legal business name | Detorres, Wayne Raymond |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811039357 | NPPES |
| New Jersey | MEDICAID | 8348001 |
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