Provider Demographics
NPI:1730297797
Name:CONSTANDIS, CALIN G (MD)
Entity Type:Individual
Prefix:DR
First Name:CALIN
Middle Name:G
Last Name:CONSTANDIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 ST. GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065
Mailing Address - Country:US
Mailing Address - Phone:732-381-0222
Mailing Address - Fax:
Practice Address - Street 1:867 ST. GEORGES AVE
Practice Address - Street 2:2
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065
Practice Address - Country:US
Practice Address - Phone:732-381-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA41432207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC55298Medicare UPIN
NJ452180Medicare ID - Type Unspecified