Provider Demographics
NPI:1396067856
Name:CONSTANTINE, JAMES
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:CONSTANTINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 W MONTAUK HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-4094
Mailing Address - Country:US
Mailing Address - Phone:631-728-4030
Mailing Address - Fax:
Practice Address - Street 1:39 W MONTAUK HWY STE 4
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-4094
Practice Address - Country:US
Practice Address - Phone:631-728-4030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038012183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist