NPIMap

Organization Active NPI

Great Lakes Electrophysiological Testing Services

  • Specialist
  • Farmington Hills, MI
National Provider Identifier
1992855639
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GREAT LAKES ELECTROPHYSIOLOGICAL TESTING SERVICES
Practice address
28959 Augusta
Farmington Hills, MI 48331-4822
Phone
(248) 489-1771
Fax
(248) 489-1771
NPI assigned
Jan 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Chyawan Kumar Bansil, PT, PH.D.NPI 1306933908
Title
President
Phone
(248) 489-1771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

28959 Augusta
Farmington Hills, MI 48331-4822

Mailing address

28959 Augusta
Farmington Hills, MI 48331-4822
Phone (248) 489-1771

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992855639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28959 AUGUSTA",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483314822",
            "telephone_number": "248-489-1771",
            "fax_number": "248-489-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28959 AUGUSTA",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483314822",
            "telephone_number": "248-489-1771",
            "fax_number": "248-489-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES ELECTROPHYSIOLOGICAL TESTING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANSIL",
        "authorized_official_first_name": "CHYAWAN",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-489-1771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, PH.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.