Provider Demographics
NPI:1710955612
Name:CONSTANTINE, VERONICA ANN (OD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:ANN
Last Name:CONSTANTINE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ROUSER ROAD
Mailing Address - Street 2:BLDG 2 SUITE 100
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108
Mailing Address - Country:US
Mailing Address - Phone:412-299-8444
Mailing Address - Fax:412-299-8443
Practice Address - Street 1:400 ROUSER ROAD
Practice Address - Street 2:BLDG 2 SUITE 100
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108
Practice Address - Country:US
Practice Address - Phone:412-299-8444
Practice Address - Fax:412-299-8443
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001069152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA223198OtherEYE MED
PAC0381167OtherBCBS
PA15987OtherSPECTERA
PA6716TOtherUBA
PA214061OtherUPMC
PA86887OtherHEALTH AMERICA
PA0011361480002OtherACCESS
PA396952OtherNVA
PA0009206OtherDORAL
PA539952Medicaid
PA15987OtherSPECTERA
PA6716TOtherUBA