Minnesota Vascular Medicine and Birthmark Center

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

41861 Issued in MN

Legal business name

MINNESOTA VASCULAR MEDICINE AND BIRTHMARK CENTER

Practice address

14050 Nicollet Ave
Suite 202
Burnsville, MN 55337-5710

Phone

(952) 892-3308

NPI assigned

Jun 25, 2008

Last updated

Jun 25, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Christina Delfanian

Title

Office Manager

Phone

(952) 892-3308

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1932361565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 NICOLLET AVE",
            "address_2": "SUITE 202",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553375710",
            "telephone_number": "952-892-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 NICOLLET AVE",
            "address_2": "SUITE 202",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553375710",
            "telephone_number": "952-892-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA VASCULAR MEDICINE AND BIRTHMARK CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "DELFANIAN",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "952-892-3308",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MN",
            "license": "41861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minnesota Oncology Hematology, PA
• Minnesota Oncology Hematology, PA
• Minnesota Oncology Hematology, PA
• Minnesota Senior Living, LLC (The Rivers)
• Minnesota Valley Surgery Center LLC
• Minnesota We Care Home Health Care, LLC
• Miracle Ear, Inc
• Camellia Mirkazemi
• Kristofer James Miron
• Yelena Sergeevna Mironova-Chin, MD

• Medical Specialty Clinic/Center in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Medical Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.