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Individual

ALTAF HOSSAIN KHONDAKAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
2236 MARSHALL AVE, SAINT PAUL, MN 55104-5799
(651) 659-0208
(651) 659-0161
Mailing address
2236 MARSHALL AVE, SAINT PAUL, MN 55104-5799
(651) 659-0208
(651) 659-0161

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 182467-0
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
868K1CA
BCBS
Enumeration date
09/03/2010
Last updated
09/03/2010
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