Provider Demographics
NPI:1053521526
Name:TORTU, JOHN P
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:TORTU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 CONTINENTAL AVE
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1604
Mailing Address - Country:US
Mailing Address - Phone:484-401-1405
Mailing Address - Fax:
Practice Address - Street 1:4221 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:PARKESBURG
Practice Address - State:PA
Practice Address - Zip Code:19365
Practice Address - Country:US
Practice Address - Phone:484-401-1405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07319900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ36717Medicare UPIN