Provider Demographics
NPI:1134219207
Name:CONSTANTIN, CHRISTINA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:CONSTANTIN
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 1:24 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8858
Mailing Address - Country:US
Mailing Address - Phone:212-533-5332
Mailing Address - Fax:212-533-5337
Practice Address - Street 1:24 5TH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8858
Practice Address - Country:US
Practice Address - Phone:212-533-5332
Practice Address - Fax:212-533-5337
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0510921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02500934Medicare ID - Type Unspecified