Provider Demographics
NPI:1205942752
Name:DAURIA, COLIN KENNETH (MD)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:KENNETH
Last Name:DAURIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 WARREN RD UNIT 3250
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-9998
Mailing Address - Country:US
Mailing Address - Phone:607-288-3522
Mailing Address - Fax:607-306-9515
Practice Address - Street 1:2309 N TRIPHAMMER RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1060
Practice Address - Country:US
Practice Address - Phone:607-257-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2661552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry