# MINNESOTA ONCOLOGY HEMATOLOGY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205606316
- **Authorized official:** JENNIFER TEICHROEW (BUSINESS OFFICE MANAGER)
- **Authorized official phone:** (651) 602-5360

## Contact information

- **Practice address:** 2550 UNIVERSITY AVE W STE 105N, SAINT PAUL, MN 55114-1052
- **Practice address phone:** (651) 602-5335
- **Practice address fax:** (651) 414-3101
- **Mailing address:** 2550 UNIVERSITY AVE W STE 110N, SAINT PAUL, MN 55114-8693
- **Mailing address phone:** (651) 602-5335

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RH0000X | Hematology (Internal Medicine) Physician | — | NULL | — |
| 207RH0000X | Hematology (Internal Medicine) Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |
| 207RX0202X | Medical Oncology Physician | — | NULL | — |
| 207RX0202X | Medical Oncology Physician | — | — | — |
| 207VX0201X | Gynecologic Oncology Physician | — | NULL | — |
| 207VX0201X | Gynecologic Oncology Physician | — | — | — |
| 2085R0001X | Radiation Oncology Physician | — | NULL | — |
| 2085R0001X | Radiation Oncology Physician | — | — | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/09/2024
- **Last updated:** 01/09/2024