Beresneva, Olga

Beresneva, Olga is an individual health care provider with primary practice located at 830 Harrison Ave Moakley, Suite 3500, Boston MA 02118. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is her primary health care specialty. Beresneva, Olga can be contacted via phone (617) 414-8054.

Contact Information

Primary practice address
830 Harrison Ave Moakley, Suite 3500 Boston MA 02118
Fax: (617) 414-8055
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 281960 Massachusetts
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 281960 Massachusetts

Profile Details

NPI number 1114345741
LBN Legal business name Beresneva, Olga
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2014
Last updated Mar 18th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114345741 NPPES
New Hampshire MEDICAID 3124180
New Hampshire MEDICAID 110109294A

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