Provider Demographics
NPI:1083301261
Name:DURAN, DORIS O (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:O
Last Name:DURAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 WADSWORTH AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3156
Mailing Address - Country:US
Mailing Address - Phone:917-385-4539
Mailing Address - Fax:
Practice Address - Street 1:358 WADSWORTH AVE APT 21
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-3156
Practice Address - Country:US
Practice Address - Phone:917-385-4539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY881390012080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine