1255664082 NPI number — BETH STAENBERG NACHMAN OT

Table of content: BETH STAENBERG NACHMAN OT (NPI 1255664082)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255664082 NPI number — BETH STAENBERG NACHMAN OT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NACHMAN
Provider First Name:
BETH
Provider Middle Name:
STAENBERG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STAENBERG
Provider Other First Name:
BETH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1255664082
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8200 DODGE ST
Provider Second Line Business Mailing Address:
CHILDREN'S HOSPITAL & MEDICAL CENTER
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68114-4113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-955-5400
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8200 DODGE ST
Provider Second Line Business Practice Location Address:
CHILDREN'S HOSPITAL & MEDICAL CENTER - REHAB SERVICES
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68114-4113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-955-3980
Provider Business Practice Location Address Fax Number:
402-955-5368
Provider Enumeration Date:
09/11/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XP0200X , with the licence number:  3 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)