Healthcare Provider Details

I. General information

NPI: 1144555178
Provider Name (Legal Business Name): KATSUMI NEENO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2341 TRADITION LN
JANESVILLE WI
53545-0723
US

IV. Provider business mailing address

2341 TRADITION LN
JANESVILLE WI
53545-0723
US

V. Phone/Fax

Practice location:
  • Phone: 608-754-0999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number12669-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: