Provider Demographics
NPI:1821185380
Name:DURANTE, LAURENCE (MD)
Entity Type:Individual
Prefix:
First Name:LAURENCE
Middle Name:
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 1:350 JEFFERSON HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-3224
Mailing Address - Country:US
Mailing Address - Phone:504-913-8572
Mailing Address - Fax:504-309-2584
Practice Address - Street 1:350 JEFFERSON HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-3224
Practice Address - Country:US
Practice Address - Phone:504-913-8572
Practice Address - Fax:504-309-2584
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0180972083P0500X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1980480Medicaid
LA5R166Medicare ID - Type Unspecified
LAE54708Medicare UPIN