Provider Demographics
NPI:1598022147
Name:KOSTUN, ZACHARY WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:WILLIAM
Last Name:KOSTUN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6 WELLNESS WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2156
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:6 WELLNESS WAY STE G02
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2135
Practice Address - Country:US
Practice Address - Phone:518-782-3900
Practice Address - Fax:518-782-3844
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2024-04-12
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Provider Licenses
StateLicense IDTaxonomies
NY2886772086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery