Healthcare Provider Details

I. General information

NPI: 1538231501
Provider Name (Legal Business Name): VICTOR A NEUFELD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 02/02/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2210 EAST LASALLE STREET SUITE 107
COLORADO SPRINGS CO
80909-3885
US

IV. Provider business mailing address

2210 EAST LASALLE STREET SUITE 107
COLORADO SPRINGS CO
80909-3885
US

V. Phone/Fax

Practice location:
  • Phone: 719-651-1204
  • Fax: 719-218-9393
Mailing address:
  • Phone: 719-651-1204
  • Fax: 719-218-9393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1552
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: