Individual
THENU MANIKANTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
265 BENTON DR, STE 105, EAST LONGMEADOW, MA 01028-3219
(413) 224-2727
(413) 224-2799
Mailing address
265 BENTON DR, STE 105, EAST LONGMEADOW, MA 01028-3219
(413) 224-2727
(413) 224-2799
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
209825
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
209825
MA
Other
Enumeration date
10/27/2005
Last updated
07/17/2016
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