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NPI Code Detail

MEDICARE: DURETI OMER

MEDICARE: DURETI OMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianMN

General Provider Information

NPI Number : 1720942055
Entity Type Code : Individual
Provider Name (Legal Business Name) : DURETI OMER
Provider Business Mailing Address
First Line : 9012 CAHILL AVE
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55076-3543
Country : US
Telephone Number : 651-350-7968
Fax Number :
Provider Business Practice Location Address
First Line : 9012 CAHILL AVE
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55076-3543
Country : US
Telephone Number : 651-350-7968
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2025
Last Update Date : 12/11/2025

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Directions to “ DURETI OMER ” Practice Location

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