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General NPI Number Information
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NPI Number | 1649846445
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Entity Type | Individual
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Provider Name | MOHANA PREESHA PARTHEEBAN
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Gender | Female
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 2500 COMO AVE
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City | SAINT PAUL
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State | MN
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Zip | 55108-1460
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Country | US
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Telephone | 651-641-6200
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Fax |
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Provider Business Mailing Address
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Address Line | THE WRIGHT CENTER, 501 SOUTH WASHINGTON AVE
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City | SCRANTON
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State | PA
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Zip | 18505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 79509
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License Number State | MN
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