Provider Demographics
NPI:1376777615
Name:KLIMOVITSKY, SARA (PT)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:KLIMOVITSKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 KINGSTON AVE
Mailing Address - Street 2:# 355
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4333
Mailing Address - Country:US
Mailing Address - Phone:917-592-1452
Mailing Address - Fax:
Practice Address - Street 1:383 KINGSTON AVE
Practice Address - Street 2:# 355
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4333
Practice Address - Country:US
Practice Address - Phone:917-592-1452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020164-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist