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NPI Code Detail

MEDICARE: ANDREW DURET LPN

MEDICARE:   ANDREW  DURET  LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251J00000XNursing Care Agency

General Provider Information

NPI Number : 1184027609
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW DURET LPN
Provider Business Mailing Address
First Line : 10543 FLATLANDS 4TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-4633
Country : US
Telephone Number : 347-825-6169
Fax Number :
Provider Business Practice Location Address
First Line : 105-43 FLATLANDS 4 STREET
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-4633
Country : US
Telephone Number : 347-825-6169
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2014
Last Update Date : 09/29/2014

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