Basic Information
Provider Information
NPI: 1083033328
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNCAN
FirstName: AUBREY
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 ELMWOOD AVE BOX 631
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146420001
CountryCode: US
TelephoneNumber: 5852752808
FaxNumber: 5852753683
Practice Location
Address1: 601 ELMWOOD AVE BOX 777R
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146420001
CountryCode: US
TelephoneNumber: 5852754174
FaxNumber: 5854426580
Other Information
ProviderEnumerationDate: 04/15/2014
LastUpdateDate: 10/15/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2084N0402X298131NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology

No ID Information.


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