Provider Demographics
NPI:1376969824
Name:FELKL, VICTORIA I (MD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:I
Last Name:FELKL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:ISABEL
Other - Last Name:MARROQUIN DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 WALL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1518
Mailing Address - Country:US
Mailing Address - Phone:603-668-4111
Mailing Address - Fax:
Practice Address - Street 1:2 WALL ST STE 400
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101
Practice Address - Country:US
Practice Address - Phone:603-668-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA138187174400000X
NH186602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist