Provider Demographics
NPI:1780448522
Name:EUGENE, CONSTANCE C
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:C
Last Name:EUGENE
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 1:202 SCHLEY ST APT 221
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2354
Mailing Address - Country:US
Mailing Address - Phone:917-676-9047
Mailing Address - Fax:
Practice Address - Street 1:147 PRINCE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3022
Practice Address - Country:US
Practice Address - Phone:917-676-9047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist