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General NPI Number Information
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NPI Number | 1497570956
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Entity Type | Individual
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Provider Name | NICOLE GENEVIEVE DUREN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 120 CORPORATE WOODS STE 350
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City | ROCHESTER
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State | NY
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Zip | 14623-1455
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Country | US
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Telephone | 585-273-4767
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Fax |
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Provider Business Mailing Address
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Address Line | 86 WISCONSIN ST
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City | ROCHESTER
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State | NY
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Zip | 14609-7545
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Country | US
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Telephone | 585-857-8513
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051304243
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 071990
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License Number State | NY
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