Individual
MR. MICHAEL E TORTORELLO I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
21 SOUTH RD, DERMATOLOGY, FARMINGTON, CT 06032-2410
(860) 679-4600
(860) 679-1248
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000653
CT
363AS0400X
Surgical Physician Assistant
000653
CT
Other
Enumeration date
02/27/2008
Last updated
06/15/2012
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