Provider Demographics
NPI:1205831450
Name:LOSYEV, SERGEY (DPM)
Entity Type:Individual
Prefix:MR
First Name:SERGEY
Middle Name:
Last Name:LOSYEV
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 BAY 26 STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:718-645-4324
Mailing Address - Fax:718-504-3595
Practice Address - Street 1:153 BAY 26 STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-7813
Practice Address - Country:US
Practice Address - Phone:718-645-4324
Practice Address - Fax:718-504-3595
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005775213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist