Provider Demographics
NPI:1154468122
Name:SCHNAUE-CONSTANTOURIS, EILEEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:
Last Name:SCHNAUE-CONSTANTOURIS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 VETERANS MEMORIAL HWY
Mailing Address - Street 2:SUITE#1
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3452
Mailing Address - Country:US
Mailing Address - Phone:631-462-2033
Mailing Address - Fax:631-462-3511
Practice Address - Street 1:69 VETERANS MEMORIAL HWY
Practice Address - Street 2:SUITE#1
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3452
Practice Address - Country:US
Practice Address - Phone:631-462-2033
Practice Address - Fax:631-462-3511
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005258213E00000X, 213EP0504X, 213EP1101X, 213ER0200X, 213ES0000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Not Answered213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
Not Answered213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Not Answered213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
Not Answered213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Not Answered213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU70219Medicare UPIN
NYP05891Medicare ID - Type Unspecified