Healthcare Provider Details
I. General information
NPI: 1104110212
Provider Name (Legal Business Name): EMMANUEL DURING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/06/2011
Last Update Date: 07/13/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 UNION SQ E
NEW YORK NY
10003-3314
US
IV. Provider business mailing address
10 UNION SQ E FRNT 5
NEW YORK NY
10003-3332
US
V. Phone/Fax
- Phone: 212-420-2377
- Fax:
- Phone: 212-844-8888
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 316629 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | A131016 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 316629 |
| License Number State | NY |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | R72835 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: