Individual
DR. SERGEY ZHIVOTENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2797 OCEAN PKWY, 2ND FLOOR, BROOKLYN, NY 11235-7861
(718) 576-1212
Mailing address
81 LOTUS OVAL N, VALLEY STREAM, NY 11581-2327
(516) 791-0761
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
236752
NY
2084N0600X
Clinical Neurophysiology Physician
236752
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02677663
—
NY
01
—
07305
GHI MEDICARE
NY
Enumeration date
07/16/2006
Last updated
03/28/2010
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