Individual
MR. CONSTANTINE FERNANDEZ GULMATICO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-5942
(718) 780-3287
Mailing address
2345 56TH DR, BROOKLYN, NY 11234-6820
(917) 755-4843
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
014230
NY
Other
Enumeration date
09/29/2010
Last updated
02/27/2018
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