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General NPI Number Information
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NPI Number | 1952648305
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Entity Type | Individual
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Provider Name | DARA VICTORIA FERNANDEZ DURAN MD
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Gender | Female
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Dates
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Enumeration Date | 01/04/2013
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 75-59 263RD STREET ZUCKER HILLSIDE HOSPITAL
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City | GLEN OAKS
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State | NY
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Zip | 11004
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Country | US
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Telephone | 718-470-5727
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Fax |
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Provider Business Mailing Address
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Address Line | 75-59 263RD STREET ZHH (1 SOUTH)
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City | GLEN OAKS
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State | NY
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Zip | 11004-5504
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Country | US
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Telephone | 718-470-5717
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A163385
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 287422
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License Number State | NY
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