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General NPI Number Information
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NPI Number | 1053538181
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Entity Type | Individual
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Provider Name | NINA A KONSTANTINOVA MD
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 423 W 55TH ST
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City | NEW YORK
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State | NY
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Zip | 10019-4460
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Country | US
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Telephone | 212-994-4583
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Fax |
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Provider Business Mailing Address
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Address Line | 6136 84TH PL
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City | MIDDLE VLG
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State | NY
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Zip | 11379-1413
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Country | US
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Telephone | 718-396-2176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 241147
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 241147
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License Number State | NY
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