Provider Demographics
NPI:1538187919
Name:NEFFINGER, GEORGE GAIL (PHD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:GAIL
Last Name:NEFFINGER
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 1:3663 BRIDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-7745
Mailing Address - Country:US
Mailing Address - Phone:845-358-1134
Mailing Address - Fax:801-697-7059
Practice Address - Street 1:3663 BRIDGEWATER DR
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-7745
Practice Address - Country:US
Practice Address - Phone:845-358-1134
Practice Address - Fax:801-697-7059
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4493103T00000X
NC5187103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV71241Medicare ID - Type Unspecified