Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 308854 | NY |
NPI | 1013491695 |
---|---|
Provider Name | Lauren Michelle Durante |
First Address | Seaford, NY 11783-2155 |
Second Address | Woodbury, NY 11797-2906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2018 |
Last Update Date | 19/09/2018 |