Individual
MARY CONSTANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
99 E STATE ST, GLOVERSVILLE, NY 12078-1203
(518) 773-5780
Mailing address
454 MAPLE AVE, SARATOGA SPRINGS, NY 12866-5532
(518) 587-1141
(518) 587-1152
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F335787
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NY
Enumeration date
07/02/2009
Last updated
07/02/2009
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