Basic Information
| Provider Information | |||||||||
| NPI: | 1548798317 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KONSTANTINOU | ||||||||
| FirstName: | ELENI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | MASSACHUSETTS GENERAL HOSPITAL | ||||||||
| Address2: | 55 FRUIT ST. | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177262800 | ||||||||
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| Practice Location | |||||||||
| Address1: | TUFTS MEDICAL CENTER | ||||||||
| Address2: | 800 WASHINGTON STREET | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176364648 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2017 | ||||||||
| LastUpdateDate: | 04/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 271189 | MA | N | Allopathic & Osteopathic Physicians | Ophthalmology | 208600000X | 271189 | MA | N | Allopathic & Osteopathic Physicians | Surgery | 207W00000X | RS2021-0034 | NM | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.