Provider Demographics
NPI:1821497017
Name:DURANTI, AISHA
Entity Type:Individual
Prefix:MRS
First Name:AISHA
Middle Name:
Last Name:DURANTI
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:AISHA
Other - Middle Name:
Other - Last Name:NUNEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 S CENTRAL AVE APT C10
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-3158
Mailing Address - Country:US
Mailing Address - Phone:347-698-4157
Mailing Address - Fax:
Practice Address - Street 1:300 S CENTRAL AVE APT C10
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-3158
Practice Address - Country:US
Practice Address - Phone:347-698-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY700582131174400000X
NY700870131174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist