Provider Demographics
NPI:1710624630
Name:ZAGORODNEV, KIRILL (MD)
Entity type:Individual
Prefix:MR
First Name:KIRILL
Middle Name:
Last Name:ZAGORODNEV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E. ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-464-5910
Mailing Address - Fax:315-464-1937
Practice Address - Street 1:750 E. ADAMS ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-5910
Practice Address - Fax:315-464-1937
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2025-08-11
Deactivation Date:2023-01-13
Deactivation Code:
Reactivation Date:2023-01-30
Provider Licenses
StateLicense IDTaxonomies
NY337956208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist