MEDICARE: RYAN CONSTANTINE M.D., PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0107X	Retina Specialist (Ophthalmology) Physician	MD493400	PA

General Provider Information

NPI Number	:	1932527199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN CONSTANTINE M.D., PHD

Provider Business Mailing Address
First Line	:	300 STATE ST STE 201
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16507-1429
Country	:	US
Telephone Number	:	814-456-4241
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 STATE ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16507-1427
Country	:	US
Telephone Number	:	814-456-4241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2014
Last Update Date	:	01/20/2026

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