Healthcare Provider Details

I. General information

NPI: 1326039363
Provider Name (Legal Business Name): PAUL DURA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 RIVERSIDE DR SUITE 302
BINGHAMTON NY
13905-4176
US

IV. Provider business mailing address

161 RIVERSIDE DR SUITE 302
BINGHAMTON NY
13905-4176
US

V. Phone/Fax

Practice location:
  • Phone: 607-798-1842
  • Fax: 607-729-0147
Mailing address:
  • Phone: 607-798-1842
  • Fax: 607-729-0147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number1766651
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD047446L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: