Provider Demographics
NPI:1528044211
Name:DONATO, EDSEN (PT, DSC, OCS, CHT)
Entity type:Individual
Prefix:
First Name:EDSEN
Middle Name:
Last Name:DONATO
Suffix:
Gender:M
Credentials:PT, DSC, OCS, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 S 48TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-4345
Mailing Address - Country:US
Mailing Address - Phone:402-486-2528
Mailing Address - Fax:402-486-2578
Practice Address - Street 1:3800 S 48TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-4345
Practice Address - Country:US
Practice Address - Phone:402-486-2528
Practice Address - Fax:402-486-2578
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251H1200X, 2251X0800X
NE4577225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR269923Medicaid
ORR131982Medicare PIN