Provider Demographics
NPI:1023606670
Name:TOTONCHY, MANHAL
Entity type:Individual
Prefix:
First Name:MANHAL
Middle Name:
Last Name:TOTONCHY
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 1:235 OLD CONNECTICUT PATH
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4575
Mailing Address - Country:US
Mailing Address - Phone:508-820-0903
Mailing Address - Fax:
Practice Address - Street 1:235 OLD CONNECTICUT PATH
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4575
Practice Address - Country:US
Practice Address - Phone:508-820-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26109183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist