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General NPI Number Information
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NPI Number | 1407175102
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Entity Type | Organization
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Legal Business Name | SYNAPSE NEURODIAGNOSTICS
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 6418 MISSION CT
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City | W BLOOMFIELD
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State | MI
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Zip | 48324-1398
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Country | US
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Telephone | 248-330-3520
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Fax | 248-856-1770
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Provider Business Mailing Address
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Address Line | 6418 MISSION CT
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City | W BLOOMFIELD
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State | MI
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Zip | 48324-1398
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Country | US
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Telephone | 248-330-3520
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Fax | 488-561-7702
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | GREGORY LUKASIK
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Credential |
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Telephone | 248-330-3520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2472E0500X
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Taxonomy Name | EEG Technician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 246ZE0500X
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Taxonomy Name | EEG Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #6
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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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