Provider Demographics
NPI:1467821322
Name:CONSTANZO, JASMINE (DO)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:
Last Name:CONSTANZO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 172ND ST
Mailing Address - Street 2:APARTMENT 12B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2333
Mailing Address - Country:US
Mailing Address - Phone:415-706-2734
Mailing Address - Fax:
Practice Address - Street 1:500 W 172ND ST
Practice Address - Street 2:APARTMENT 12B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-2333
Practice Address - Country:US
Practice Address - Phone:415-706-2734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program