Provider Demographics
NPI:1265471726
Name:DURANT, CHRISTOPHER S (MD)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:S
Last Name:DURANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:652 SUFFOLK AVENUE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717
Mailing Address - Country:US
Mailing Address - Phone:631-617-5181
Mailing Address - Fax:631-617-5182
Practice Address - Street 1:652 SUFFOLK AVENUE
Practice Address - Street 2:SUITE 210
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717
Practice Address - Country:US
Practice Address - Phone:631-617-5181
Practice Address - Fax:631-617-5182
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY166030207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01342850Medicaid
NY36F321Medicare ID - Type Unspecified