Provider Demographics
NPI:1659359743
Name:TOLLINCHE, MARCEL P (MD)
Entity Type:Individual
Prefix:MR
First Name:MARCEL
Middle Name:P
Last Name:TOLLINCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:MARCEL
Other - Middle Name:PHILLIP
Other - Last Name:TOLLINCHI RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1875 CARR 2 SUITE 208
Mailing Address - Street 2:MEDICAL OPHTHALMIC PLAZA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7217
Mailing Address - Country:US
Mailing Address - Phone:787-780-2612
Mailing Address - Fax:787-780-2234
Practice Address - Street 1:CARRETERA 2 KMIL.9 SUITE 208
Practice Address - Street 2:MEDICAL OPHTHALMIC PLAZA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7217
Practice Address - Country:US
Practice Address - Phone:787-780-2612
Practice Address - Fax:787-780-2234
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4723207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR96533Medicare PIN
PRE31178Medicare UPIN