Provider Demographics
NPI:1497285811
Name:ROBLES, CONSTANTIN NAUTNAY (ND)
Entity Type:Individual
Prefix:
First Name:CONSTANTIN
Middle Name:NAUTNAY
Last Name:ROBLES
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:CONSTANTIN
Other - Middle Name:JAEN
Other - Last Name:NAUTNAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3600 FORBES AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3600 FORBES AVE STE 140
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3410
Practice Address - Country:US
Practice Address - Phone:412-647-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2021-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT213549390200000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program