Organization
GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY SC
Active
Parent organization
GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY SC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY SC
Authorized official
LORI A SMITH (OFFICE MANAGER)
(847) 816-6441
Entity
Organization
Contact information
Practice address
4600 GREEN BAY RD, KENOSHA, WI 53144-1719
(262) 286-1860
Mailing address
PO BOX 14545, BELFAST, ME 04915-4038
(847) 816-6335
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084N0400X
Neurology Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
2084V0102X
Vascular Neurology Physician
—
—
363A00000X
Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
02/13/2024
Last updated
01/17/2025
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