Healthcare Provider Details

I. General information

NPI: 1265557045
Provider Name (Legal Business Name): KATALIN SZANISZLO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 12/08/2021
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 2ND ST NICU
NEENAH WI
54956-2883
US

IV. Provider business mailing address

130 2ND ST NICU
NEENAH WI
54956-2883
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number43025
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: