Provider Demographics
NPI:1164400040
Name:DURANTE, BERNARD JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:JOSEPH
Last Name:DURANTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ALDRIN ROAD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-746-8977
Mailing Address - Fax:508-746-3364
Practice Address - Street 1:30 ALDRIN ROAD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360
Practice Address - Country:US
Practice Address - Phone:508-746-8977
Practice Address - Fax:508-746-3364
Is Sole Proprietor?:No
Enumeration Date:2006-01-02
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58069207KI0005X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3022811Medicaid
MA19073OtherHARVARD PILGRIM HEALTH
MA2652138OtherAETNA
MA043585201OtherHEALTHCAREVALUEMANAGEMENT
MA040016605OtherRAILROAD MEDICARE
MA711390OtherTUFTS HEALTH PLAN
MAB20014301OtherCIGNA
MAJ06669OtherBLUECROSSBLUESHIELD
MA1000029OtherUNITED HEALTHCARE
MAJ06669Medicare ID - Type Unspecified
MAA66495Medicare UPIN
MA3022811Medicaid