Provider Demographics
NPI:1982760302
Name:ZOLTAN, EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:ZOLTAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:38 6TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4187
Mailing Address - Country:US
Mailing Address - Phone:718-230-7788
Mailing Address - Fax:718-230-8017
Practice Address - Street 1:175 REMSEN ST STE 1225
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4320
Practice Address - Country:US
Practice Address - Phone:718-230-7788
Practice Address - Fax:718-230-8017
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY242393208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2008BEL811Medicare PIN
NY2008B1Medicare PIN