Healthcare Provider Details

I. General information

NPI: 1861199317
Provider Name (Legal Business Name): ROSANNA DURAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 NEW DORP LN
STATEN ISLAND NY
10306-3035
US

IV. Provider business mailing address

55 MAIN ST FL 3
YONKERS NY
10701-2739
US

V. Phone/Fax

Practice location:
  • Phone: 518-606-6021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number014527
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: