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Individual

MR. KENNETH HOSTEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
96 LAFAYETTE ST, PLATTSBURGH, NY 12901-1542
(518) 578-2818
Mailing address
5446 PERU ST APT 2, PLATTSBURGH, NY 12901-3497

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
705894655
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
705894655
DL
NY
Enumeration date
08/24/2022
Last updated
10/18/2022
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