Provider Demographics
NPI:1598737967
Name:KONSTADT, JODY W (MD)
Entity Type:Individual
Prefix:MRS
First Name:JODY
Middle Name:W
Last Name:KONSTADT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:700 WHITE PLAINS RD
Mailing Address - Street 2:STE #30
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-725-3700
Mailing Address - Fax:914-725-3885
Practice Address - Street 1:700 WHITE PLAINS RD
Practice Address - Street 2:STE 30
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-725-3700
Practice Address - Fax:914-725-3885
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY185558207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE84290Medicare UPIN
NY82F361Medicare ID - Type Unspecified