NPIMap

Organization Active NPI

Tracey Torosian, PH.D., PLLC

  • Clinic/Center
  • Saint Clair Shores, MI
National Provider Identifier
1700181211
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
6301009014 Issued in MI
Legal business name
TRACEY TOROSIAN, PH.D., PLLC
Practice address
20816 E 11 Mile Rd
Suite 112
Saint Clair Shores, MI 48081-1565
Phone
(586) 774-7344
Fax
(586) 774-7345
NPI assigned
Jan 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tracey Torosian, PH.D.
Title
Sole Proprietor
Phone
(586) 774-7344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 6301009014 MI Primary

Addresses

Primary practice location

20816 E 11 Mile Rd
Suite 112
Saint Clair Shores, MI 48081-1565

Mailing address

20816 E 11 Mile Rd
Suite 112
Saint Clair Shores, MI 48081-1565
Phone (586) 774-7344

Other identifiers 2

IdentifierTypeStateIssuer
1962531335OtherMINPI TYPE 1
680E046090OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1700181211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20816 E 11 MILE RD",
            "address_2": "SUITE 112",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811565",
            "telephone_number": "586-774-7344",
            "fax_number": "586-774-7345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20816 E 11 MILE RD",
            "address_2": "SUITE 112",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811565",
            "telephone_number": "586-774-7344",
            "fax_number": "586-774-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACEY TOROSIAN, PH.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "TOROSIAN",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "586-774-7344",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "6301009014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1962531335",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "680E046090",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.