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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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