Individual
SERGE KIANOVSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.T.
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
016388
NY
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
016388
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016388
HIP
NY
05
—
02012040
—
NY
01
—
11081573
MULTIPLAN
NY
01
—
136981
CHN
NY
01
—
177236
ELDER PLAN
NY
01
—
3C6820
HEALTH NET
NY
01
—
6698961
GHI
NY
01
—
833574
EMPIRE PLAN (MPN)
NY
01
—
BK0224704
AMERICHOICE
NY
01
—
P2459083
OXFORD
NY
01
—
QC2011
EMPIRE BCBS
NY
Enumeration date
06/20/2006
Last updated
09/11/2025
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