Provider Demographics
NPI:1003390766
Name:DURINO, ALI MICHELLE (APN)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:MICHELLE
Last Name:DURINO
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 1:112 MILLBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HARDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07825-9531
Mailing Address - Country:US
Mailing Address - Phone:973-534-1966
Mailing Address - Fax:
Practice Address - Street 1:112 MILLBROOK RD
Practice Address - Street 2:
Practice Address - City:HARDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07825-9531
Practice Address - Country:US
Practice Address - Phone:973-534-1966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00835900363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner