Provider Demographics
NPI:1467831404
Name:DUROSEAU, NATHALIE HELEN (DO)
Entity Type:Individual
Prefix:DR
First Name:NATHALIE
Middle Name:HELEN
Last Name:DUROSEAU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 CIVIC CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4395
Mailing Address - Country:US
Mailing Address - Phone:631-806-7340
Mailing Address - Fax:
Practice Address - Street 1:3550 CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN HOSPITAL OF PHILADELPHIA BUERGER CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC7-0005907208000000X
PAOS021364208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics