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General NPI Number Information
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NPI Number | 1487075818
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Entity Type | Individual
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Provider Name | CHRISTOS CONSTANTATOS
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Gender | Male
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Dates
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Enumeration Date | 01/03/2014
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 389-391 PENINSULA BLVD STE E
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City | HEMPSTEAD
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State | NY
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Zip | 11550
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Country | US
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Telephone | 516-280-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 389 PENINSULA BLVD STE 391E
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City | HEMPSTEAD
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State | NY
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Zip | 11550-4914
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 058879
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License Number State | NY
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