Healthcare Provider Details

I. General information

NPI: 1265377824
Provider Name (Legal Business Name): TREY STEVEN MENAGH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W SOUTH 21ST ST
YORK NE
68467-9316
US

IV. Provider business mailing address

1400 OLD FARM RD APT 34
LINCOLN NE
68512-1867
US

V. Phone/Fax

Practice location:
  • Phone: 308-381-1690
  • Fax:
Mailing address:
  • Phone: 402-239-2892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: