Provider Demographics
NPI:1043041742
Name:COSTANTINO, CHRISTINA M
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:COSTANTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1166 LAFAYETTE RD LOT E14
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-2482
Mailing Address - Country:US
Mailing Address - Phone:330-321-7295
Mailing Address - Fax:
Practice Address - Street 1:1166 LAFAYETTE RD LOT F13
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3529
Practice Address - Country:US
Practice Address - Phone:330-834-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide