Provider Demographics
NPI:1598240582
Name:MIREILLE CONSTANT, MD, PC
Entity Type:Organization
Organization Name:MIREILLE CONSTANT, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MIREILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSTANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-859-3927
Mailing Address - Street 1:3250 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-1441
Mailing Address - Country:US
Mailing Address - Phone:631-859-3927
Mailing Address - Fax:631-859-3046
Practice Address - Street 1:3250 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-1441
Practice Address - Country:US
Practice Address - Phone:631-859-3927
Practice Address - Fax:631-859-3046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty