Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 75433 | GA |
NPI | 1083903561 |
---|---|
Provider Name | Tina Constantin |
First Address | New York, NY 10006-1995 |
Second Address | New York, NY 10006-1995 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2011 |
Last Update Date | 13/03/2021 |