Provider Demographics
NPI:1013900513
Name:STAROSTA, ZALMAN D (MD)
Entity Type:Individual
Prefix:MR
First Name:ZALMAN
Middle Name:D
Last Name:STAROSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 CONEY ISLAND AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5255
Mailing Address - Country:US
Mailing Address - Phone:718-943-3000
Mailing Address - Fax:718-943-3006
Practice Address - Street 1:3044 CONEY ISLAND AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5255
Practice Address - Country:US
Practice Address - Phone:718-943-3000
Practice Address - Fax:718-943-3006
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01068799Medicaid
NY01068799Medicaid
A61186Medicare UPIN