Provider Demographics
NPI:1386089167
Name:BERNARD J. DURANTE,MD,PC
Entity type:Organization
Organization Name:BERNARD J. DURANTE,MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:DURANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC,DBA
Authorized Official - Phone:508-746-8977
Mailing Address - Street 1:30 ALDRIN RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4804
Mailing Address - Country:US
Mailing Address - Phone:508-746-8977
Mailing Address - Fax:508-747-9680
Practice Address - Street 1:55 OBERY ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2181
Practice Address - Country:US
Practice Address - Phone:508-746-8977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BERNARD J. DURANTE, MD,PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-07
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58069291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory