Mag LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MAG LLC

Practice address

11737 Wentling Avenue
Suite a
Baton Rouge, LA 70816-6053

Phone

(225) 413-7375

Fax

(225) 208-1400

NPI assigned

Jan 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bruce Grizzaffi

Title

Ceo/Partner

Phone

(225) 413-7375

Specialties & licenses 1

Addresses

Other names 1

• NEURO DIAGNOSTIC ASSOCIATES Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1295911527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8738 GRAND VIEW DRIVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708095230",
            "telephone_number": "225-413-7375",
            "fax_number": "225-208-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11737 WENTLING AVENUE",
            "address_2": "SUITE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166053",
            "telephone_number": "225-413-7375",
            "fax_number": "225-208-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "GRIZZAFFI",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CEO/PARTNER",
        "authorized_official_telephone_number": "225-413-7375"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEURO DIAGNOSTIC ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Baton Rouge, LA
• Physiological Laboratory in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.