# DR. GARY J. KOSTEK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1750374948
- **Gender:** Man
- **Credential:** D.C.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X006972-1 | NY | Yes |

## Other

- **Enumeration date:** 08/24/2005
- **Last updated:** 08/16/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 002113491 | BC/BS PROVIDER \# | NY |
| 01 | — | 161439044 | PRISM PROVIDER \# | NY |
| 01 | — | 35002855-2 | RAILROAD MEDICARE | NY |
| 01 | — | 5800965 | GHI PROVIDER \# | NY |
| 01 | — | 8809538 | IHA PROVIDER \# | NY |
| 01 | — | 911157 | MPN PROVIDER \# | NY |
| 01 | — | C06972-6B | WC PROVIDER \# | NY |