Provider Demographics
NPI:1073720777
Name:NEONATAL ASSOCIATES OF WISCONSIN S.C.
Entity Type:Organization
Organization Name:NEONATAL ASSOCIATES OF WISCONSIN S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATALIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SZANISZLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-969-7990
Mailing Address - Street 1:PO BOX 13005
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54307-3005
Mailing Address - Country:US
Mailing Address - Phone:920-496-1134
Mailing Address - Fax:920-496-1135
Practice Address - Street 1:130 2ND ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2883
Practice Address - Country:US
Practice Address - Phone:920-969-7990
Practice Address - Fax:920-969-7969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31545700OtherEDS MA
WINO25999OtherCORPORATE ID #
WI2258200OtherGROUP #
WI575577-2OtherSTATE OF WI EMPLOYEE ID #