Provider Demographics
NPI:1790018380
Name:PSYCHIATRIC ASSOCIATES OF LINCOLN P.C.
Entity Type:Organization
Organization Name:PSYCHIATRIC ASSOCIATES OF LINCOLN P.C.
Other - Org Name:ELI S. CHESEN M.D.,P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELI
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHESEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-488-5765
Mailing Address - Street 1:1919 S 40TH ST
Mailing Address - Street 2:SUITE # 320
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5243
Mailing Address - Country:US
Mailing Address - Phone:402-488-5765
Mailing Address - Fax:402-488-6709
Practice Address - Street 1:1919 S 40TH ST
Practice Address - Street 2:SUITE # 320
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5243
Practice Address - Country:US
Practice Address - Phone:402-488-5765
Practice Address - Fax:402-488-6709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE120222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEB90767Medicare UPIN