Provider Demographics
NPI:1295885705
Name:YAROVOY, SERGEY (PT)
Entity type:Individual
Prefix:
First Name:SERGEY
Middle Name:
Last Name:YAROVOY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 E 8TH ST APT 5F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2748
Mailing Address - Country:US
Mailing Address - Phone:917-749-3971
Mailing Address - Fax:718-373-7583
Practice Address - Street 1:2925 W 5TH ST STE 52
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3962
Practice Address - Country:US
Practice Address - Phone:917-749-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2022-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018969-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist