Provider Demographics
NPI:1174556229
Name:VOYTENKO, CONSTANTINE (DC)
Entity type:Individual
Prefix:DR
First Name:CONSTANTINE
Middle Name:
Last Name:VOYTENKO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 W 5TH ST
Mailing Address - Street 2:SUITE # 12A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4166
Mailing Address - Country:US
Mailing Address - Phone:718-676-2424
Mailing Address - Fax:718-676-2424
Practice Address - Street 1:2101 EAST 16TH STREET
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-339-0050
Practice Address - Fax:718-645-6600
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008974111N00000X
NJ38MC00637600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02083681Medicaid
NYU72020Medicare UPIN
NY02083681Medicaid