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
Phone: (617) 414-8054
Fax: (617) 414-8055
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1114345741 | NPPES |
New Hampshire | MEDICAID | 3124180 | |
New Hampshire | MEDICAID | 110109294A |
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