Healthcare Provider Details

I. General information

NPI: 1477474013
Provider Name (Legal Business Name): CYRTHA DURAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25919 149TH RD
ROSEDALE NY
11422-3005
US

IV. Provider business mailing address

25919 149TH RD
ROSEDALE NY
11422-3005
US

V. Phone/Fax

Practice location:
  • Phone: 917-418-2077
  • Fax:
Mailing address:
  • Phone: 917-418-2077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0900X
TaxonomyEnterostomal Therapy Registered Nurse
License Number579322-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: