Provider Demographics
NPI:1073527602
Name:DURYEA, HOWARD (PA)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:DURYEA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:65 BRIAR CREEK PLZ
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-4100
Practice Address - Country:US
Practice Address - Phone:570-802-5590
Practice Address - Fax:570-802-5591
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY009213363A00000X
PAMA051201363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD3728649OtherDEA
NYMD2886476OtherDEA
NYMD2886476OtherDEA