Provider Demographics
NPI:1538231501
Name:NEUFELD, VICTOR A (PHD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:A
Last Name:NEUFELD
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:2210 EAST LASALLE STREET
Mailing Address - Street 2:SUITE 107
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-3885
Mailing Address - Country:US
Mailing Address - Phone:719-651-1204
Mailing Address - Fax:719-218-9393
Practice Address - Street 1:2210 EAST LASALLE STREET
Practice Address - Street 2:SUITE 107
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3885
Practice Address - Country:US
Practice Address - Phone:719-651-1204
Practice Address - Fax:719-218-9393
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1552103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC61066Medicare PIN