Provider Demographics
NPI:1649831983
Name:DIAZ DURAN, ELIANA MARIA (MD)
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:MARIA
Last Name:DIAZ 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 1:406 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-1499
Mailing Address - Country:US
Mailing Address - Phone:814-827-1851
Mailing Address - Fax:
Practice Address - Street 1:339 W SPRING ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-1655
Practice Address - Country:US
Practice Address - Phone:814-827-9675
Practice Address - Fax:814-827-4750
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD479022208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics