Healthcare Provider Details

I. General information

NPI: 1578765608
Provider Name (Legal Business Name): VINCENT DURON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 BROADWAY, 2ND FLOOR CHN-N
NEW YORK NY
10032-2739
US

IV. Provider business mailing address

PO BOX 27036
NEW YORK NY
10087-7036
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-8585
  • Fax: 877-316-6162
Mailing address:
  • Phone: 212-305-9576
  • Fax: 212-305-9480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number25MA10291700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number280080
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberLP01137
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: