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NPI Code Detail

MEDICARE: TAMARA BRACCIANO OTR/L

MEDICARE: TAMARA BRACCIANO OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist1196NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255682613
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA BRACCIANO OTR/L
Provider Business Mailing Address
First Line : 13336 INDUSTRIAL RD
Second Line : SUITE 105
City : OMAHA
State : NE
Zip : 68137-1124
Country : US
Telephone Number : 402-330-3211
Fax Number : 402-330-5970
Provider Business Practice Location Address
First Line : 5321 S 138TH ST
Second Line :
City : OMAHA
State : NE
Zip : 68137-2913
Country : US
Telephone Number : 402-895-4000
Fax Number : 866-895-8245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2012
Last Update Date : 11/21/2018

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Directions to “ TAMARA BRACCIANO OTR/L” Practice Location

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