Provider Demographics
NPI:1518243963
Name:ROCHESTER MATH & SCIENCE ACADEMY
Entity Type:Organization
Organization Name:ROCHESTER MATH & SCIENCE ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULKADIR
Authorized Official - Middle Name:DAHIR
Authorized Official - Last Name:ABDALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-600-0739
Mailing Address - Street 1:415 16TH ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-2125
Mailing Address - Country:US
Mailing Address - Phone:507-252-5995
Mailing Address - Fax:507-252-8003
Practice Address - Street 1:415 16TH ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-2125
Practice Address - Country:US
Practice Address - Phone:507-252-5995
Practice Address - Fax:507-252-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty