Provider Demographics
NPI:1699259861
Name:CANCHANYA, JOSELYNE
Entity type:Individual
Prefix:
First Name:JOSELYNE
Middle Name:
Last Name:CANCHANYA
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 1:66 RANNEY ST
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-4001
Mailing Address - Country:US
Mailing Address - Phone:860-794-0246
Mailing Address - Fax:
Practice Address - Street 1:66 RANNEY ST
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-4001
Practice Address - Country:US
Practice Address - Phone:860-794-0246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program