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General NPI Number Information
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NPI Number | 1851544357
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Entity Type | Individual
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Provider Name | CAROL YVETTE DURAND RPA-C
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Gender | Female
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 10201 66TH RD
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City | FOREST HILLS
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State | NY
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Zip | 11375-2029
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Country | US
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Telephone | 347-228-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 14411 77TH RD APT. B
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City | FLUSHING
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State | NY
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Zip | 11367-3426
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Country | US
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Telephone | 347-228-7774
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 008796
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00170500
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License Number State | NJ
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