Provider Demographics
NPI:1760489652
Name:CONSTANTINE, JILL M (MD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:CONSTANTINE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:520 JEFFERSON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-527-8060
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:601 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-2433
Practice Address - Country:US
Practice Address - Phone:724-523-2323
Practice Address - Fax:724-523-2754
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2017-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD040340L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001132579Medicaid
PAE64246Medicare UPIN
PA538632Medicare PIN