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General NPI Number Information
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NPI Number | 1881743953
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Entity Type | Individual
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Provider Name | REBEKAH RADMANESH M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 3301 7TH AVE STE 104
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City | ANOKA
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State | MN
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Zip | 55303-4516
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Country | US
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Telephone | 651-431-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 LABORE RD. SUITE 104
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City | VADNAIS HEIGHTS
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State | MN
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Zip | 55110-5186
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Country | US
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Telephone |
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Fax | 651-431-7505
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 103297
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 75886
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License Number State | MN
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