Provider Demographics
NPI:1659842953
Name:MARTEL, LES F (PHD)
Entity Type:Individual
Prefix:DR
First Name:LES
Middle Name:F
Last Name:MARTEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 STONE RIDGE WAY APT 1D
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5381
Mailing Address - Country:US
Mailing Address - Phone:203-887-6981
Mailing Address - Fax:
Practice Address - Street 1:389 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2301
Practice Address - Country:US
Practice Address - Phone:203-887-6981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-12
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001281103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical