Provider Demographics
NPI:1437317997
Name:PERTILLAR, TOSCHA M (MSW)
Entity Type:Individual
Prefix:MS
First Name:TOSCHA
Middle Name:M
Last Name:PERTILLAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 NORTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-1534
Mailing Address - Country:US
Mailing Address - Phone:888-793-3500
Mailing Address - Fax:860-793-3520
Practice Address - Street 1:999 ASYLUM AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2416
Practice Address - Country:US
Practice Address - Phone:860-548-0030
Practice Address - Fax:860-548-4100
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2017-01-19
Deactivation Date:2012-04-24
Deactivation Code:
Reactivation Date:2017-01-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker