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General NPI Number Information
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NPI Number | 1679141378
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Entity Type | Organization
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Legal Business Name | REGIONAL FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 1047 UNIVERSITY AVE W STE 101
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City | SAINT PAUL
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State | MN
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Zip | 55104-4751
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Country | US
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Telephone | 651-666-0846
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Fax | 651-256-3008
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Provider Business Mailing Address
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Address Line | 2189 GATEWAY HILL RD N
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City | NORTH SAINT PAUL
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State | MN
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Zip | 55109-1776
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Country | US
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Telephone | 651-666-0846
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | HASSAN HUSSEIN SIRAT
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Credential | NP
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Telephone | 651-666-0846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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