Healthcare Provider Details

I. General information

NPI: 1295187110
Provider Name (Legal Business Name): MARY HASCHKE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2016
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11606 NICHOLAS ST
OMAHA NE
68154-4478
US

IV. Provider business mailing address

11606 NICHOLAS ST
OMAHA NE
68154-4478
US

V. Phone/Fax

Practice location:
  • Phone: 402-493-2020
  • Fax:
Mailing address:
  • Phone: 402-493-2020
  • Fax: 402-493-8987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number32581
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: