Provider Demographics
NPI:1851511810
Name:PLENTZAS, CONSTANTINA
Entity Type:Individual
Prefix:
First Name:CONSTANTINA
Middle Name:
Last Name:PLENTZAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 MOCCASIN PATH
Mailing Address - Street 2:
Mailing Address - City:ATKINSON
Mailing Address - State:NH
Mailing Address - Zip Code:03811-2360
Mailing Address - Country:US
Mailing Address - Phone:603-362-9656
Mailing Address - Fax:
Practice Address - Street 1:34 NASHUA RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3406
Practice Address - Country:US
Practice Address - Phone:603-432-5897
Practice Address - Fax:603-432-1167
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2647183500000X
MA20778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist