Provider Demographics
NPI:1598766537
Name:CONSTANTINO, CASSANDRA XAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:XAVIER
Last Name:CONSTANTINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 HOPE ST.
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-1126
Mailing Address - Country:US
Mailing Address - Phone:401-253-8900
Mailing Address - Fax:401-253-3131
Practice Address - Street 1:1180 HOPE ST.
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-1126
Practice Address - Country:US
Practice Address - Phone:401-253-8900
Practice Address - Fax:401-253-3131
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD9173207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI406102OtherTUFTS HEALTH PLANS
RI005361OtherBCHIP
RI04-00762OtherUNITED HEALTHCARE
RI3868OtherNEIGHBORHOOD HEALTH PLANS
RI7005500Medicaid
RI0000020323OtherB/S
RI697701OtherHARVARD PILGRIM HEALTH
RI0000020323OtherB/S