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NPI Code Detail

MEDICARE: MR. SERGEY LOSYEV DPM

MEDICARE: MR. SERGEY LOSYEV DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristN005775NY

General Provider Information

NPI Number : 1205831450
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SERGEY LOSYEV DPM
Provider Business Mailing Address
First Line : 153 BAY 26 STREET
Second Line :
City : BROOKLYN
State : NY
Zip : 11214
Country : US
Telephone Number : 718-645-4324
Fax Number : 718-504-3595
Provider Business Practice Location Address
First Line : 153 BAY 26 STREET
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-7813
Country : US
Telephone Number : 718-645-4324
Fax Number : 718-504-3595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 06/10/2010

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