Healthcare Provider Details

I. General information

NPI: 1316218548
Provider Name (Legal Business Name): EMMA DURAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2012
Last Update Date: 09/26/2021
Certification Date: 09/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 KATONAH AVE STE H
KATONAH NY
10536-2193
US

IV. Provider business mailing address

5 PEACH RD
MAHOPAC NY
10541-5327
US

V. Phone/Fax

Practice location:
  • Phone: 149-458-1921
  • Fax:
Mailing address:
  • Phone: 347-416-2609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number019208-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number019208-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: