Provider Demographics
NPI:1427381607
Name:ALBANY, COSTANTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:COSTANTINE
Middle Name:
Last Name:ALBANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 UNITY PL
Mailing Address - Street 2:STE 345
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5761
Mailing Address - Country:US
Mailing Address - Phone:765-446-5111
Mailing Address - Fax:765-838-0972
Practice Address - Street 1:535 BARNHILL DR
Practice Address - Street 2:IU SIMON CANCER CENTER RT 473
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5116
Practice Address - Country:US
Practice Address - Phone:317-948-6942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-06
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN01068345A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01068345AOtherINDIANA'S PROFESSIONAL LICENSING
INP01262165OtherRAILROAD MEDICARE
IN201107150Medicaid
IN264910015Medicare PIN