Provider Demographics
NPI:1487975728
Name:FEHNEL, KATIE PRICOLA (MD)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:PRICOLA
Last Name:FEHNEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:L
Other - Last Name:PRICOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BOSTON CHILDREN'S HOSPITAL
Mailing Address - Street 2:300 LONGWOOD AVE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-355-7795
Mailing Address - Fax:617-730-0906
Practice Address - Street 1:BOSTON CHILDREN'S HOSPITAL
Practice Address - Street 2:300 LONGWOOD AVE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-7795
Practice Address - Fax:617-730-0906
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA262816207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery