Provider Demographics
NPI:1477282267
Name:NEUFVILLE, MAXINE YVONNE
Entity Type:Individual
Prefix:
First Name:MAXINE
Middle Name:YVONNE
Last Name:NEUFVILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 MANCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06112-1454
Mailing Address - Country:US
Mailing Address - Phone:860-726-3829
Mailing Address - Fax:
Practice Address - Street 1:86 MANCHESTER ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112-1454
Practice Address - Country:US
Practice Address - Phone:860-726-3829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide