Provider Demographics
NPI:1477967982
Name:LAMBROUSSIS, CONSTANTINO GEORGE (DO)
Entity Type:Individual
Prefix:DR
First Name:CONSTANTINO
Middle Name:GEORGE
Last Name:LAMBROUSSIS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:571 SAINT JOSEPHS BLVD
Mailing Address - Street 2:FL 2
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3230
Mailing Address - Country:US
Mailing Address - Phone:607-271-2050
Mailing Address - Fax:607-873-1244
Practice Address - Street 1:200 MADISON AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3218
Practice Address - Country:US
Practice Address - Phone:607-732-1310
Practice Address - Fax:607-733-0940
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2021-05-19
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Provider Licenses
StateLicense IDTaxonomies
NY291753207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program