Provider Demographics
NPI:1669479283
Name:CONSTANTINO, ANGELO (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:
Last Name:CONSTANTINO
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BUCKINGHAM RD
Mailing Address - Street 2:OFFICE SUITE 1500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-1505
Mailing Address - Country:US
Mailing Address - Phone:412-578-0270
Mailing Address - Fax:
Practice Address - Street 1:121 FREEPORT RD STE 200
Practice Address - Street 2:
Practice Address - City:BLAWNOX
Practice Address - State:PA
Practice Address - Zip Code:15238-3485
Practice Address - Country:US
Practice Address - Phone:412-784-2323
Practice Address - Fax:412-784-2320
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-29
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042865E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1244691Medicaid
671094Medicare ID - Type Unspecified
C57897Medicare UPIN