MEDICARE: KIM CONTARDI PAREIGAT MA LP

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
1	103TC1900X	Counseling Psychologist	LP1110	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	124530	OTHER	UCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	990991000193	OTHER	PREFERRED ONE
4	187725	OTHER	VALUE OPTIONS
5	6229339	OTHER	MEDICAL SELECT CARE
6	9L834PA	OTHER	BCBS BLUE PLUS
7	191026	OTHER	MAGO MANAGEMENT

General Provider Information

NPI Number	:	1255313839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM CONTARDI PAREIGAT MA LP

Provider Business Mailing Address
First Line	:	1900 SILVER LAKE RD NW STE 110
Second Line	:
City	:	NEW BRIGHTON
State	:	MN
Zip	:	55112-1789
Country	:	US
Telephone Number	:	651-628-9566
Fax Number	:	651-628-0411

Provider Business Practice Location Address
First Line	:	1900 SILVER LAKE RD NW STE 110
Second Line	:
City	:	NEW BRIGHTON
State	:	MN
Zip	:	55112-1789
Country	:	US
Telephone Number	:	651-628-9566
Fax Number	:	651-628-0411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	03/26/2018

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Directions to “ KIM CONTARDI PAREIGAT MA LP” Practice Location

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