Healthcare Provider Details

I. General information

NPI: 1356252845
Provider Name (Legal Business Name): YONAITHESSA DURE BERNARD PHLEBOTOMIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 S MAIN ST STE 15
MILFORD MA
01757-3272
US

IV. Provider business mailing address

15 WASHINGTON ST APT 16
PLAINVILLE MA
02762-2657
US

V. Phone/Fax

Practice location:
  • Phone: 774-523-7780
  • Fax: 774-523-7781
Mailing address:
  • Phone: 519-924-4410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberNPCN-17838-19381
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: