MEDICARE: LISETTE B DURHAM LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	334800	NY

General Provider Information

NPI Number	:	1528937984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISETTE B DURHAM LPN

Provider Business Mailing Address
First Line	:	11573 227TH ST
Second Line	:
City	:	CAMBRIA HEIGHTS
State	:	NY
Zip	:	11411-1428
Country	:	US
Telephone Number	:	631-336-1535
Fax Number	:

Provider Business Practice Location Address
First Line	:	380 ROCKAWAY TPKE
Second Line	:
City	:	CEDARHURST
State	:	NY
Zip	:	11516-1122
Country	:	US
Telephone Number	:	631-208-4460
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	11/03/2025

Similar Medicare Providers

1902548969 — STEVEN GOLD MD
Practice Location Address:

380 ROCKAWAY TPKE
CEDARHURST, NY
11516-1122

Practice Phone: 718-868-4804
Practice Fax:

1548522493 — DR. SANJIDA SHOMA CABOT M.D., PH.D.
Practice Location Address:

380 ROCKAWAY TPKE
CEDARHURST, NY
11516-1122

Practice Phone: 516-858-4323
Practice Fax: 516-400-4323

1578906889 — DR. ELIZABETH EDELSTEIN D.O.
Practice Location Address:

380 ROCKAWAY TPKE
CEDARHURST, NY
11516-1122

Practice Phone: 516-487-4368
Practice Fax:

1952240848 — ALIYAH ALBERT MAUTE
Practice Location Address:

380 ROCKAWAY TPKE
CEDARHURST, NY
11516-1122

Practice Phone: 718-868-4808
Practice Fax:

1942047865 — REVOLVE MEDICAL SERVICES PC
Practice Location Address:

414 CENTRAL AVE
CEDARHURST, NY
11516-1907

Practice Phone: 347-344-7466
Practice Fax:

1992649271 — FIVE TOWNS RX INC
Practice Location Address:

136 CEDARHURST AVE
CEDARHURST, NY
11516-2130

Practice Phone: 516-295-1895
Practice Fax: 516-374-1012

Directions to “ LISETTE B DURHAM LPN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.