Healthcare Provider Details

I. General information

NPI: 1073720777
Provider Name (Legal Business Name): NEONATAL ASSOCIATES OF WISCONSIN S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 2ND ST
NEENAH WI
54956-2883
US

IV. Provider business mailing address

PO BOX 13005
GREEN BAY WI
54307-3005
US

V. Phone/Fax

Practice location:
  • Phone: 920-969-7990
  • Fax: 920-969-7969
Mailing address:
  • Phone: 920-496-1134
  • Fax: 920-496-1135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KATALIN SZANISZLO
Title or Position: PRESIDENT
Credential: MD
Phone: 920-969-7990