Provider Demographics
NPI:1417010026
Name:DINE, CONSTANCE J (MD)
Entity Type:Individual
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First Name:CONSTANCE
Middle Name:J
Last Name:DINE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3400 CIVIC CENTER BOULEVARD
Mailing Address - Street 2:WEST PAVILION-1ST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4306
Mailing Address - Country:US
Mailing Address - Phone:215-662-3202
Mailing Address - Fax:215-379-8432
Practice Address - Street 1:3400 CIVIC CENTER BOULEVARD
Practice Address - Street 2:WEST PAVILION-1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-662-3202
Practice Address - Fax:215-349-8432
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2012-08-14
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Provider Licenses
StateLicense IDTaxonomies
PAMD425693207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease