Provider Demographics
NPI:1346354172
Name:BERTONI, JOHN M (MD /PHD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:M
Last Name:BERTONI
Suffix:
Gender:M
Credentials:MD /PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4242 FARNAM ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8440
Mailing Address - Country:US
Mailing Address - Phone:402-552-8959
Mailing Address - Fax:402-559-3341
Practice Address - Street 1:UNMC NEUROLOGY
Practice Address - Street 2:982045 NEBRASKA MEDICAL CENTER
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-2045
Practice Address - Country:US
Practice Address - Phone:402-552-2921
Practice Address - Fax:402-559-3341
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE180692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEC29866Medicare UPIN
NE130007984Medicare PIN
NE097426Medicare PIN
NE088216Medicare PIN