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Specialty details in registry · New Brighton, MN

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At a glance

151 Silver Lake Rd Nw Unit 2, New Brighton, MN 55112-8101

NPPES record updated Apr 10, 2026. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

151 Silver Lake Rd Nw Unit 2
New Brighton, MN 55112-8101
Professional details: NPI, taxonomy & registry record
NPI1124961560
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
251E00000X
Enumeration date
Apr 10, 2026
Record updated
Apr 10, 2026
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

251E00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

151 Silver Lake Rd Nw Unit 2
New Brighton, MN 55112-8101
Phone
(617) 909-0230
Fax
(612) 314-8682
Mailing address
151 SILVER LAKE RD NW UNIT 2

NEW BRIGHTON, MN 551128101
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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