Organization
MDFPR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRILL V BEREJNOI M.D., (GERIATRICIAN)
(415) 314-0144
Entity
Organization
Contact information
Practice address
15 E CHESTNUT ST, AUGUSTA, ME 04330-5736
(207) 626-1889
Mailing address
32 QUARRY RD APT 33, WATERVILLE, ME 04901-4970
(415) 314-0144
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
A102844
CA
Other
Enumeration date
08/17/2008
Last updated
08/17/2008
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