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Organization
MAYA BERDZENISHVILI MD LLC
Active
Organization
MAYA BERDZENISHVILI MD LLC
Active
Other names
Maya Berdzenishvili MD LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAYA BERDZENISHVILI MD (OWNER)
(617) 262-0462
Entity
Organization
Contact information
Practice address
220 COMMONWEALTH AVE APT 4, BOSTON, MA 02116-2510
(617) 262-6402
(617) 262-6402
Mailing address
220 COMMONWEALTH AVE APT 4, BOSTON, MA 02116-2510
(617) 262-6402
(617) 262-6402
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
NULL
207RP1001X
Pulmonary Disease Physician
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
NULL
Other
Enumeration date
11/09/2020
Last updated
02/19/2024
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