Provider Demographics
NPI:1083189989
Name:NEVILLE, BARRET (NP)
Entity type:Individual
Prefix:
First Name:BARRET
Middle Name:
Last Name:NEVILLE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 SUNNYSIDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M6R2R7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 CANTERBURY PLACE
Practice Address - Street 2:
Practice Address - City:NORTH YORK
Practice Address - State:ON
Practice Address - Zip Code:M2N2N1
Practice Address - Country:CA
Practice Address - Phone:416-301-1132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0134216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine