Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 900 | NE |
N | 207XS0106X | Orthopaedic Hand Surgeon | 900 | NE |
NPI | 1013069897 |
---|---|
Provider Name | Dr. Nicholas Thomas Mansuetta |
First Address | Kearney, NE 68845-2909 |
Second Address | Kearney, NE 68845-2909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 25/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G85604 | (02) |