Provider Demographics
NPI:1043244643
Name:PATNEY, MANJU L (MD)
Entity Type:Individual
Prefix:DR
First Name:MANJU
Middle Name:L
Last Name:PATNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2206 LONGO DRIVE
Mailing Address - Street 2:STE 210
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005
Mailing Address - Country:US
Mailing Address - Phone:402-292-5594
Mailing Address - Fax:402-292-5832
Practice Address - Street 1:2206 LONGO DR STE 210
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-2977
Practice Address - Country:US
Practice Address - Phone:402-292-5594
Practice Address - Fax:402-292-5832
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE125972080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEF09785Medicare UPIN