Provider Demographics
NPI:1972530657
Name:DURAN-SORIANO, MARIA ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ELENA
Last Name:DURAN-SORIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:E
Other - Last Name:DURAN ESTRELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:91-31 QUEENS BLVD STE 322
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5540
Mailing Address - Country:US
Mailing Address - Phone:718-205-5035
Mailing Address - Fax:718-205-5701
Practice Address - Street 1:91-31 QUEENS BLVD STE 322
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5540
Practice Address - Country:US
Practice Address - Phone:718-205-5035
Practice Address - Fax:718-205-5701
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1743742084N0402X, 2084N0600X
FLME907162084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274182200Medicaid
NY01828266Medicaid
NY03595UMedicare ID - Type Unspecified
FL274182200Medicaid