| Viktorija Grajevskaja, | |
|
45 N Pine St, Port Allegany, PA 16743-1238 | |
| (814) 642-7232 | |
| Not Available |
| Full Name | Viktorija Grajevskaja |
|---|---|
| Gender | Female |
| Speciality | Dentist |
| Location | 45 N Pine St, Port Allegany, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730752619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS043320 (Pennsylvania) | Primary |
| Entity Name | Charles Cole Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326161662 PECOS PAC ID: 3779487475 Enrollment ID: O20040310001269 |
| Mailing Address | Practice Location Address |
|---|---|
| Viktorija Grajevskaja, 1001 E 2nd St, Coudersport, PA 16915-8161 Ph: () - | Viktorija Grajevskaja, 45 N Pine St, Port Allegany, PA 16743-1238 Ph: (814) 642-7232 |
Mark P Carlson, DMD Dentist Medicare: Medicare Enrolled Practice Location: 37 Pearl St, Port Allegany, PA 16743 Phone: 814-642-2661 Fax: 814-642-9388 | |
Dr. Philip L Carlson Jr., DMD Dentist Medicare: Medicare Enrolled Practice Location: 37 Pearl St, Port Allegany, PA 16743 Phone: 814-642-2661 Fax: 814-642-9388 | |
Dr. Richard A Kunkel, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 316 E Arnold Ave, Port Allegany, PA 16743 Phone: 814-642-2400 | |
Nathan P Carlson, DMD Dentist Medicare: Medicare Enrolled Practice Location: 37 Pearl St, Port Allegany, PA 16743 Phone: 814-642-2661 Fax: 814-642-9388 |