Provider Demographics
NPI:1225050966
Name:KALINOWSKI, CONSTANCE MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:MARY
Last Name:KALINOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4000 E CHARLESTON BLVD
Mailing Address - Street 2:STE 130B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104
Mailing Address - Country:US
Mailing Address - Phone:702-968-4000
Mailing Address - Fax:702-968-4040
Practice Address - Street 1:4000 E CHARLESTON BLVD
Practice Address - Street 2:STE 130B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104
Practice Address - Country:US
Practice Address - Phone:702-968-4000
Practice Address - Fax:702-968-4040
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG0687922084P0800X
NV98312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV10058035Medicaid
NV10058035Medicaid
F96326Medicare UPIN