Provider Demographics
NPI:1952648305
Name:FERNANDEZ DURAN, DARA VICTORIA (MD)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:VICTORIA
Last Name:FERNANDEZ DURAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-59 263RD STREET
Mailing Address - Street 2:ZHH (1 SOUTH)
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-5504
Mailing Address - Country:US
Mailing Address - Phone:718-470-5717
Mailing Address - Fax:
Practice Address - Street 1:75-59 263RD STREET
Practice Address - Street 2:ZUCKER HILLSIDE HOSPITAL
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004
Practice Address - Country:US
Practice Address - Phone:718-470-5727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1633852084P0800X
NY2874222084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry