Provider Demographics
NPI:1487237780
Name:CONSTANTINE, JULIA (APN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:CONSTANTINE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SYCAMORE AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1248
Mailing Address - Country:US
Mailing Address - Phone:732-747-9310
Mailing Address - Fax:
Practice Address - Street 1:34 SYCAMORE AVE STE 2A
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1248
Practice Address - Country:US
Practice Address - Phone:732-747-9310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR21004000363LW0102X
NJ26NJ01105600363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ01105600OtherAPN LICENSE NUMBER