Provider Demographics
NPI:1083960389
Name:TOKATLIAN, TALINE
Entity Type:Individual
Prefix:MRS
First Name:TALINE
Middle Name:
Last Name:TOKATLIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ACORN LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-1505
Mailing Address - Country:US
Mailing Address - Phone:617-642-7165
Mailing Address - Fax:
Practice Address - Street 1:3 ACORN LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-1505
Practice Address - Country:US
Practice Address - Phone:617-642-7165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26262183500000X
NH3088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist