Healthcare Provider Details

I. General information

NPI: 1518243963
Provider Name (Legal Business Name): ROCHESTER MATH & SCIENCE ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2011
Last Update Date: 10/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 16TH ST SW
ROCHESTER MN
55902-2125
US

IV. Provider business mailing address

415 16TH ST SW
ROCHESTER MN
55902-2125
US

V. Phone/Fax

Practice location:
  • Phone: 507-252-5995
  • Fax: 507-252-8003
Mailing address:
  • Phone: 507-252-5995
  • Fax: 507-252-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. ABDULKADIR DAHIR ABDALLA
Title or Position: PRINCIPAL
Credential:
Phone: 612-600-0739