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Organization
PHYSICAL THERAPY RESINST, PC
Active
Organization
PHYSICAL THERAPY RESINST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGE KIANOVSKI DPT (CLINICAL DIRECTOR)
(718) 232-7778
Entity
Organization
Contact information
Practice address
7803 20TH AVE, BROOKLYN, NY 11214-1207
(718) 232-7778
(718) 232-9634
Mailing address
7803 20TH AVE, BROOKLYN, NY 11214-1207
(718) 232-7778
(718) 232-9634
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
016388
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108401
HEALTH NET
NY
05
—
02195779
—
NY
01
—
QYW13
EMPIRE BC&BS
NY
Enumeration date
03/16/2007
Last updated
08/22/2020
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