Provider Demographics
NPI:1174720643
Name:NEUFELD, GREGORY (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:NEUFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-2934
Mailing Address - Country:US
Mailing Address - Phone:914-751-3524
Mailing Address - Fax:
Practice Address - Street 1:102 PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2934
Practice Address - Country:US
Practice Address - Phone:914-751-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256972207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133925128OtherPRACTICE TAX ID NUMBER