Healthcare Provider Details

I. General information

NPI: 1700193430
Provider Name (Legal Business Name): SHEIKH SWARAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 09/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7673 JUNE AVE N
BROOKLYN PARK MN
55443-3445
US

IV. Provider business mailing address

5775 WAYZATA BLVD SUITE 700
ST LOUIS PARK MN
55416-1222
US

V. Phone/Fax

Practice location:
  • Phone: 763-630-1062
  • Fax:
Mailing address:
  • Phone: 612-799-6508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: