Provider Demographics
NPI:1851709042
Name:TORTORICI, DANIELLE (RPA-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:TORTORICI
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 GOLF COURSE RD
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-7506
Mailing Address - Country:US
Mailing Address - Phone:518-212-6070
Mailing Address - Fax:
Practice Address - Street 1:375 GOLF COURSE RD
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7506
Practice Address - Country:US
Practice Address - Phone:518-212-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017581-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical