Healthcare Provider Details

I. General information

NPI: 1316108913
Provider Name (Legal Business Name): HEATHER OLLEIA TORY M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-9390
  • Fax: 860-545-9914
Mailing address:
  • Phone: 860-545-9390
  • Fax: 860-545-9914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number52807
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: