Provider Demographics
NPI:1063576205
Name:ZOLTAY, GABOR (MD)
Entity type:Individual
Prefix:DR
First Name:GABOR
Middle Name:
Last Name:ZOLTAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:99 E STATE ST
Mailing Address - Street 2:PO BOX 1250
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-1203
Mailing Address - Country:US
Mailing Address - Phone:518-775-4205
Mailing Address - Fax:518-773-5456
Practice Address - Street 1:99 E STATE ST
Practice Address - Street 2:MAB-GPCC
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-1203
Practice Address - Country:US
Practice Address - Phone:518-773-5691
Practice Address - Fax:518-773-5620
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2421472084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000412560006OtherBSH NE NY
NY02833365Medicaid
NY4152831OtherMVP HEALTHCARE
NY10118555OtherCDPHP
J400000120Medicare PIN
NY000412560006OtherBSH NE NY