1083189989 NPI number — BARRET NEVILLE NP

Table of content: BARRET NEVILLE NP (NPI 1083189989)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083189989 NPI number — BARRET NEVILLE NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEVILLE
Provider First Name:
BARRET
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083189989
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
341 SUNNYSIDE AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TORONTO
Provider Business Mailing Address State Name:
ON
Provider Business Mailing Address Postal Code:
M6R2R7
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 CANTERBURY PLACE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH YORK
Provider Business Practice Location Address State Name:
ON
Provider Business Practice Location Address Postal Code:
M2N2N1
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
416-301-1132
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/06/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  101.0134216 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)