Individual
VAISHALI SUBHASH PHATAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4242 FARNAM ST STE 550, OMAHA, NE 68131-2813
(402) 559-8600
(402) 559-5010
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
939
NE
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
939
NE
Other
Enumeration date
03/28/2007
Last updated
10/11/2017
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