Provider Demographics
NPI:1598870693
Name:TORTORA, LOUISE ELLEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:ELLEN
Last Name:TORTORA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 POST RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6038
Mailing Address - Country:US
Mailing Address - Phone:203-254-0093
Mailing Address - Fax:203-256-0547
Practice Address - Street 1:1300 POST RD
Practice Address - Street 2:SUITE 206
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6038
Practice Address - Country:US
Practice Address - Phone:203-254-0093
Practice Address - Fax:203-256-0547
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000410213E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4067484Medicaid
CT008040062OtherMEDICAID DME
CT008040062OtherMEDICAID DME
T22037Medicare UPIN
CT0723810001Medicare NSC