Provider Demographics
NPI:1740621127
Name:DURCAN, CHRISTINA B
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:B
Last Name:DURCAN
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 1:40 DOUGLAS CT
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1904
Mailing Address - Country:US
Mailing Address - Phone:845-735-4888
Mailing Address - Fax:
Practice Address - Street 1:40 DOUGLAS CT
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1904
Practice Address - Country:US
Practice Address - Phone:845-735-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist