Provider Demographics
NPI:1679514723
Name:TORRENTE, JASON A (DO)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:A
Last Name:TORRENTE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 STONEHAM DR
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1346
Mailing Address - Country:US
Mailing Address - Phone:856-209-2938
Mailing Address - Fax:888-572-0094
Practice Address - Street 1:200 FIRST RESPONDERS WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-1904
Practice Address - Country:US
Practice Address - Phone:609-249-7073
Practice Address - Fax:609-249-7074
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB073083207Q00000X, 207Q00000X
PAOS013356207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA118141223OtherDEPARTMENT OF LABOR
PA1863591OtherHIGHMARK BLUE SHIELD
PA102538360001Medicaid
PA2721770000OtherKEYSTONE IBC
PA6504869OtherAETNA HMO
PA118141223OtherDEPARTMENT OF LABOR