Healthcare Provider Details

I. General information

NPI: 1982877999
Provider Name (Legal Business Name): LINDA DURANTE D.O.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 CAMINO DE MONTE REY, STE B2
SANTA FE NM
87505-3961
US

IV. Provider business mailing address

PO BOX 326
SANTA FE NM
87504-0326
US

V. Phone/Fax

Practice location:
  • Phone: 505-424-3961
  • Fax:
Mailing address:
  • Phone: 505-424-9527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number569
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: