Basic Information
Provider Information
NPI: 1851826028
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORTI
FirstName: GABRIELLA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: TORTI
OtherFirstName: ELLA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 915 HIGHLAND BLVD
Address2:  
City: BOZEMAN
State: MT
PostalCode: 597156902
CountryCode: US
TelephoneNumber: 4064145000
FaxNumber:  
Practice Location
Address1: 915 HIGHLAND BLVD
Address2:  
City: BOZEMAN
State: MT
PostalCode: 597156902
CountryCode: US
TelephoneNumber: 8023181253
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/26/2017
LastUpdateDate: 05/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/12/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X87673MTY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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