Provider Demographics
NPI:1497893200
Name:CHAMBERLAIN, CONSTANCE GALANEK (RPH)
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:GALANEK
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6122 FIELDSTON RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1108
Mailing Address - Country:US
Mailing Address - Phone:917-696-6149
Mailing Address - Fax:
Practice Address - Street 1:973 MCLEAN AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-4108
Practice Address - Country:US
Practice Address - Phone:914-237-8821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY26240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist