Provider Demographics
NPI:1881191237
Name:DURAN, BRUNA
Entity Type:Individual
Prefix:
First Name:BRUNA
Middle Name:
Last Name:DURAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRUNA
Other - Middle Name:
Other - Last Name:CARBELIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:268 ROUTE 6N APT 2
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-4796
Mailing Address - Country:US
Mailing Address - Phone:914-469-0077
Mailing Address - Fax:
Practice Address - Street 1:268 ROUTE 6N APT 2
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-4796
Practice Address - Country:US
Practice Address - Phone:914-469-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028567235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist