NEUROTECH LLC NPI 1336780717

NPI Information

  • NPI: 1336780717
  • Provider Name: NEUROTECH, LLC
  • Classification: Physiological Laboratory - 293D00000X
  • Entity Type: Organization
  • Other Name: NEUROTECH, LLC FIXED IDTF
  • Address: 1263 MAIN ST STE 120
    GREEN BAY, WI
    ZIP 54302
  • Phone: (262) 875-6612

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NPI Details

NEUROTECH, LLC is a physiological laboratory in Green Bay, WI. The provider is a laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. NEUROTECH, LLC NPI is 1336780717. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Neurotech, Llc Fixed Idtf.

The provider's business location address is:

1263 MAIN ST STE 120
GREEN BAY, WI
ZIP 54302-341
Phone: (262) 875-6612

The provider's authorized official is Kristine Lisa Wildner .
The authorized official title is Director Of Contracting & Research and has the following contact phone number (262) 875-6572.

The enumeration date for this NPI number is 10/7/2019 and was last updated on 11/12/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12472E0500XTechnician, OtherEEGNo
2261QS1200XClinic/CenterSleep Disorder DiagnosticNo
3335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging SupplierNo
4293D00000XPhysiological LaboratoryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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