Individual
DR. RAFAEL TATAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2222 S 16TH ST, SUITE 330, LINCOLN, NE 68502-3796
(402) 474-1511
(402) 474-1611
Mailing address
5001 BRIDLE LN, 2222 SOUTH 16TH ST, SUITE 330, LINCOLN, NE 68516-3438
(402) 730-6061
(402) 474-1611
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
15956
NE
2084P0804X
Child & Adolescent Psychiatry Physician
15956
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100250661-00
—
NE
01
—
AT8023335
DDA
NE
Enumeration date
08/31/2005
Last updated
12/03/2012
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