MEDICARE: NEURO TECHNOLOGY INSTITUTE USA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1235382581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEURO TECHNOLOGY INSTITUTE USA LLC

Provider Business Mailing Address
First Line	:	3535 S SHERWOOD FOREST BLVD STE 249
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-2255
Country	:	US
Telephone Number	:	225-293-6222
Fax Number	:	225-208-1100

Provider Business Practice Location Address
First Line	:	3535 S SHERWOOD FOREST BLVD STE 249
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-2255
Country	:	US
Telephone Number	:	225-293-6222
Fax Number	:	225-208-1100

Authorized Official
Title or Position	:	OFFICER
Name	:	LISA W JANANI
Credential	:
Telephone Number	:	225-926-8880

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	11/16/2021

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