# MDFPR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467608836
- **Authorized official:** KIRILL V BEREJNOI M.D., (GERIATRICIAN)
- **Authorized official phone:** (415) 314-0144

## Contact information

- **Practice address:** 15 E CHESTNUT ST, AUGUSTA, ME 04330-5736
- **Practice address phone:** (207) 626-1889
- **Mailing address:** 32 QUARRY RD APT 33, WATERVILLE, ME 04901-4970
- **Mailing address phone:** (415) 314-0144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | A102844 | CA | Yes |

## Other

- **Enumeration date:** 08/17/2008
- **Last updated:** 08/17/2008