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General NPI Number Information
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NPI Number | 1437157765
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Entity Type | Individual
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Provider Name | JOHN B CONSTANTINE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 19 VILLAGE SQ
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City | CHELMSFORD
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State | MA
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Zip | 01824-2712
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Country | US
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Telephone | 978-256-5600
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Fax | 978-703-0250
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Provider Business Mailing Address
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Address Line | 19 VILLAGE SQ
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City | CHELMSFORD
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State | MA
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Zip | 01824-2712
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Country | US
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Telephone | 978-256-5600
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Fax | 978-703-0250
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 71751
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 71751
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License Number State | MA
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