Provider Demographics
NPI:1659562320
Name:MINAS CONSTANTINIDES, MD, FACS, P.C.
Entity Type:Organization
Organization Name:MINAS CONSTANTINIDES, MD, FACS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MINAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSTANTINIDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-861-0200
Mailing Address - Street 1:74 E 79TH ST
Mailing Address - Street 2:SUITE 1-B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0264
Mailing Address - Country:US
Mailing Address - Phone:212-861-0200
Mailing Address - Fax:212-988-5455
Practice Address - Street 1:74 E 79TH ST
Practice Address - Street 2:SUITE 1-B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0264
Practice Address - Country:US
Practice Address - Phone:212-861-0200
Practice Address - Fax:212-988-5455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW37181Medicare PIN