Provider Demographics
NPI:1922706894
Name:DURKAN, MARY KATHRYN
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:DURKAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15417 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1938
Mailing Address - Country:US
Mailing Address - Phone:718-309-5310
Mailing Address - Fax:
Practice Address - Street 1:15417 12TH AVE
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1938
Practice Address - Country:US
Practice Address - Phone:718-309-5310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist