Provider Demographics
NPI:1952466906
Name:CONSTANTINESCU, CRISTINA (DDS)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:CONSTANTINESCU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20118 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2135
Mailing Address - Country:US
Mailing Address - Phone:718-454-2442
Mailing Address - Fax:
Practice Address - Street 1:20118 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2135
Practice Address - Country:US
Practice Address - Phone:718-454-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048867122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02149686Medicaid