Provider Demographics
NPI:1245684281
Name:DURNEN, ANITA
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:DURNEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 HACKENSACK ST # 5
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-1240
Mailing Address - Country:US
Mailing Address - Phone:201-881-9773
Mailing Address - Fax:254-629-5535
Practice Address - Street 1:481 HACKENSACK AVE FL 2
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-6330
Practice Address - Country:US
Practice Address - Phone:201-881-9773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00626500363LP0808X, 363LF0000X
PASP021319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily