Provider Demographics
NPI:1114243052
Name:TARASCHENKO, OLGA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:TARASCHENKO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:OLHA
Other - Middle Name:
Other - Last Name:TARASCHENKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, DO
Mailing Address - Street 1:4242 FARNAM ST STE 650
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY, EMORY UNIV SCHOOL OF MEDICINE
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2813
Mailing Address - Country:US
Mailing Address - Phone:402-559-8600
Mailing Address - Fax:402-559-5010
Practice Address - Street 1:4242 FARNAM ST STE 650
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY, EMORY UNIV SCHOOL OF MEDICINE
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131
Practice Address - Country:US
Practice Address - Phone:402-559-8600
Practice Address - Fax:402-559-5010
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NE285992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
81545OtherUNKNOWN