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General NPI Number Information
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NPI Number | 1336936889
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Entity Type | Individual
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Provider Name | LHEZUANNE DE VERA CONSTANTINO
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Gender | Female
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 1345 AVENUE OF THE AMERICAS FL 2
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City | NEW YORK
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State | NY
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Zip | 10105-0008
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Country | US
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Telephone | 121-298-1197
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Fax | 164-678-6402
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Provider Business Mailing Address
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Address Line | 4200 N FALCON DR APT UNIT58
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City | GOODYEAR
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State | AZ
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Zip | 85395-2302
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Country | US
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Telephone | 602-813-1617
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State | NY
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