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Individual

DR. GARY J. KOSTEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
8643 SHERIDAN DR, WILLIAMSVILLE, NY 14221-6315
(716) 634-4133
(716) 634-4140
Mailing address
8643 SHERIDAN DR, WILLIAMSVILLE, NY 14221-6315
(716) 634-4133
(716) 634-4140

Taxonomy

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

Other

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
Enumeration date
08/24/2005
Last updated
08/16/2024
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