Provider Demographics
NPI:1548922578
Name:SIERGIEJ, ALAN ROBERT
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:ROBERT
Last Name:SIERGIEJ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-3127
Mailing Address - Country:US
Mailing Address - Phone:718-659-5800
Mailing Address - Fax:
Practice Address - Street 1:425 KINGSTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-3127
Practice Address - Country:US
Practice Address - Phone:718-659-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist