Basic Information
| Provider Information | |||||||||
| NPI: | 1326011958 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERENJI | ||||||||
| FirstName: | KAMBEEZ | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3339 | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224023339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8557399953 | ||||||||
| FaxNumber: | 5716599445 | ||||||||
| Practice Location | |||||||||
| Address1: | 4004 GENESEE PL | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | WOODBRIDGE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221928303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8557399953 | ||||||||
| FaxNumber: | 5716599445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 03/07/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 0101242617 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207RC0000X | 0101242617 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.