Organization
OAK NORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONSTANTINOS CONSTANTINOU MD (MANAGER)
(914) 450-4038
Entity
Organization
Contact information
Practice address
773 MAIN ST, MANCHESTER, CT 06040-5102
(860) 870-1300
(860) 870-1306
Mailing address
773 MAIN ST, MANCHESTER, CT 06040-5102
(914) 450-4038
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
043819
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001438193
—
CT
Enumeration date
05/28/2014
Last updated
12/05/2022
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