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Individual

PETER MONACO CIMINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11704 W CENTER RD, STE 200, OMAHA, NE 68144-4375
(402) 691-0500
(402) 505-6249
Mailing address
11704 W CENTER RD, STE 200, OMAHA, NE 68144-4375
(402) 691-0500
(402) 505-6249

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
16362
NE
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
16362
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0755
BCBS PROVIDER NUMBER
NE
05
09283
IA
01
093431
NE MEDICARE GROUP
NE
05
0937078
IA
01
16362
NE MEDICAL LICENSE
NE
01
2000-10322
RR MEDICARE
NE
05
470533149212
NE
01
CJ6643
RR MEDICARE GROUP
NE
Enumeration date
02/16/2006
Last updated
03/07/2023
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