Individual
JORGE LUCAS P CONSTANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2231 BURDETT AVE, STE 160, TROY, NY 12180-2447
(518) 292-6200
(518) 292-6228
Mailing address
7 SOUTHWOODS BLVD, ALBANY, NY 12211-2526
(518) 292-6000
(518) 292-6050
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
176852
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01132723
—
NY
01
—
060067417
RR MEDICARE
NY
05
—
1007540
—
VT
05
—
2011794
—
MA
Enumeration date
09/12/2005
Last updated
01/30/2015
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