Provider Demographics
NPI:1316707045
Name:DUREN, KATHRYN H (PA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:H
Last Name:DUREN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:H
Other - Last Name:DUREN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:712 E FAYETTE ST APT 404
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1546
Mailing Address - Country:US
Mailing Address - Phone:704-600-8257
Mailing Address - Fax:
Practice Address - Street 1:712 E FAYETTE ST APT 404
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1546
Practice Address - Country:US
Practice Address - Phone:704-600-8257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program