Healthcare Provider Details

I. General information

NPI: 1407580541
Provider Name (Legal Business Name): ZLATKO KRASIMIROV KOSTADINOV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2022
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WOODS RD
VALHALLA NY
10595-1530
US

IV. Provider business mailing address

825 NEW YORK AVE APT 809
BROOKLYN NY
11203-2720
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-6316
  • Fax:
Mailing address:
  • Phone: 929-272-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: