Provider Demographics
NPI:1316233380
Name:CONSTANT, ISLANDE (RN)
Entity type:Individual
Prefix:
First Name:ISLANDE
Middle Name:
Last Name:CONSTANT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2304
Mailing Address - Country:US
Mailing Address - Phone:516-547-5336
Mailing Address - Fax:
Practice Address - Street 1:17 GRANT AVE
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2304
Practice Address - Country:US
Practice Address - Phone:516-547-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY594957163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY594957OtherRN LICENSE