Healthcare Provider Details

I. General information

NPI: 1124258306
Provider Name (Legal Business Name): GEETANJALI SINGH RATHORE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982167 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2167
US

IV. Provider business mailing address

310 N 40TH ST APARTMENT 10
OMAHA NE
68131-2376
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-5380
  • Fax:
Mailing address:
  • Phone: 402-889-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6136
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberV4060
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: