Doctor Name: | MARTA TOCHACEK |
NPI Number: | 1992776900 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 32455 |
Business Practice Address: | 1200 Lagoon Ave Minneapolis, MN - 554082077 |
Business Phone Number: | 6128236300 |
Business Fax Number: | |
Mailing Address: | 7949 Woodpark Blvd, WOODBURY |
State: | MN |
Postal Code: | 551253368 |
Phone Number: | 6517316142 |
Fax Number: | |
NPI Enumeration Date: | 01/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 32455 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |