MEDICARE: DR. MICHAEL TORTORICI OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	27OA00554800	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00010562	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3003169	OTHER	NJ	AETNA HMO
2	3213245	OTHER	NJ	CIGNA PPO
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	C232G1	OTHER	NJ	WELLCHOICE
5	P2522906	OTHER	NJ	OXFORD FREEDOM
7	0323606000	OTHER	NJ	AMERIHEALTH
8	090005448NJ01	OTHER	NJ	ANTHEM
9	2K1488	OTHER	NJ	HEALTHNET
10	5338698	OTHER	NJ	AETNA

General Provider Information

NPI Number	:	1578643961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL TORTORICI OD

Provider Business Mailing Address
First Line	:	619 RIVER DR
Second Line	:	PHILLIPS EYE CENTER
City	:	ELMWOOD PARK
State	:	NJ
Zip	:	07407-1317
Country	:	US
Telephone Number	:	201-796-2020
Fax Number	:	201-796-2833

Provider Business Practice Location Address
First Line	:	619 RIVER DR
Second Line	:	PHILLIPS EYE CENTER
City	:	ELMWOOD PARK
State	:	NJ
Zip	:	07407-1317
Country	:	US
Telephone Number	:	201-796-2020
Fax Number	:	201-796-2833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	02/15/2012

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Directions to “ DR. MICHAEL TORTORICI OD” Practice Location

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