MEDICARE: NORTHEAST COLLEGE PREP

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1760889240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHEAST COLLEGE PREP

Provider Business Mailing Address
First Line	:	2511 TAYLOR ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-3731
Country	:	US
Telephone Number	:	612-248-8240
Fax Number	:

Provider Business Practice Location Address
First Line	:	2511 TAYLOR ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-3731
Country	:	US
Telephone Number	:	612-248-8240
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CARL PHILLIPS
Credential	:
Telephone Number	:	612-986-7089

Provider Enumeration Date	:	11/26/2014
Last Update Date	:	11/26/2014

Similar Medicare Providers

1629931472 — AMANI OMAR HUSSEIN
Practice Location Address:

2511 TAYLOR ST NE
MINNEAPOLIS, MN
55418-3731

Practice Phone: 612-432-0481
Practice Fax: 612-520-5204

1780843755 — NE DINNERBELL MEALS ON WHEELS
Practice Location Address:

2511 TAYLOR ST NE
MINNEAPOLIS, MN
55418-3731

Practice Phone: 612-623-3363
Practice Fax:

1174274252 — EARLY INTERVENTION THERAPY LLC
Practice Location Address:

2501 TAYLOR ST NE # 1A
MINNEAPOLIS, MN
55418-3731

Practice Phone: 952-200-4338
Practice Fax:

1104529247 — SUNDUS ABDIAZIZ MOHAMED
Practice Location Address:

2501 TAYLOR ST NE # 1A
MINNEAPOLIS, MN
55418-3731

Practice Phone: 952-200-4338
Practice Fax:

1073216115 — LINA FUAD ABDO
Practice Location Address:

2501 TAYLOR ST NE # 1A
MINNEAPOLIS, MN
55418-3731

Practice Phone: 952-200-4338
Practice Fax: 612-324-4106

1003511874 — SALMAN ALI YUSUF
Practice Location Address:

2501 TAYLOR ST NE # 1A
MINNEAPOLIS, MN
55418-3731

Practice Phone: 952-200-4338
Practice Fax: 612-324-4106

Directions to “NORTHEAST COLLEGE PREP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.