Provider Demographics
NPI:1528091592
Name:FEKE, TANYA (MD)
Entity type:Individual
Prefix:DR
First Name:TANYA
Middle Name:
Last Name:FEKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MITCHELL POND RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1241
Mailing Address - Country:US
Mailing Address - Phone:603-818-4007
Mailing Address - Fax:888-717-9847
Practice Address - Street 1:125 INDIAN ROCK RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-2008
Practice Address - Country:US
Practice Address - Phone:603-890-6330
Practice Address - Fax:603-458-7626
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16266207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT01445031Medicaid
CT044503OtherCT STATE LICENSE
CT044503OtherCT STATE LICENSE
CTI59494Medicare UPIN