Provider Demographics
NPI:1548762537
Name:ZISKIN, CONSTANCE ANNA (RN)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:ANNA
Last Name:ZISKIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-2912
Mailing Address - Country:US
Mailing Address - Phone:518-843-4805
Mailing Address - Fax:518-843-6184
Practice Address - Street 1:210 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-2912
Practice Address - Country:US
Practice Address - Phone:518-843-4805
Practice Address - Fax:518-843-6184
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY512339163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool