Provider Demographics
NPI:1639727597
Name:DUROVICH, ELIZABETH NATASHA (PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:NATASHA
Last Name:DUROVICH
Suffix:
Gender:F
Credentials:PMHNP-BC
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Mailing Address - Street 1:515 MADISON AVE FL 21
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5433
Mailing Address - Country:US
Mailing Address - Phone:929-276-1696
Mailing Address - Fax:914-999-8520
Practice Address - Street 1:515 MADISON AVE FL 21
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5433
Practice Address - Country:US
Practice Address - Phone:929-276-1696
Practice Address - Fax:914-999-8520
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJNJDCATEMP-025091363LP0808X
FL104363LP0808X
AZ239247363LP0808X
NY402788363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health