Basic Information
| Provider Information | |||||||||
| NPI: | 1679100663 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAWFIK | ||||||||
| FirstName: | MONIKA | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 PARK AVE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554151623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6128733000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 715 S 8TH ST | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554041210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6128736963 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2020 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P2201X | 124572 | MN | N | 1835P1200X | 124572 | MN | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
ID Information
| ID | Type | State | Issuer | Description | 124572 | 01 | MN | MINNESOTA BOARD OF PHARMACY | OTHER |