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General NPI Number Information
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NPI Number | 1306658000
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Entity Type | Organization
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Legal Business Name | NEURODIAGNOSTIC SUPPORT SERVICE, INC
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 2741 EXECUTIVE PARK DR STE 4
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City | WESTON
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State | FL
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Zip | 33331-3641
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Country | US
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Telephone | 407-468-3137
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Fax |
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Provider Business Mailing Address
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Address Line | 17520 DARTOWN RD UNIT 467
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City | WESTFIELD
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State | IN
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Zip | 46074-9836
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Country | US
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Telephone | 407-468-3137
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TODD J LANG
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Credential |
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Telephone | 407-468-3137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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