Provider Demographics
NPI:1144910258
Name:TORRES, PELU (OPTICIAN)
Entity type:Individual
Prefix:
First Name:PELU
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-9607
Mailing Address - Country:US
Mailing Address - Phone:484-554-5252
Mailing Address - Fax:570-424-8751
Practice Address - Street 1:355 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-2814
Practice Address - Country:US
Practice Address - Phone:570-424-8728
Practice Address - Fax:570-424-8751
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA150945156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician