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1114303278
CARLY DETOR
SYRACUSE, NY
NPI
1114303278
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NY 339796)
Enumeration Date
2015-07-30
Last Update Date
2015-07-30
Business Address
-- CARLY DETOR NP
104 UNION AVE SUITE 1001-1002
SYRACUSE, NY 13203-1843
Phone number: 315-423-7192
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Mailing Address
-- CARLY DETOR NP
104 UNION AVE SUITE 1001-1002
SYRACUSE, NY 13203-1843
Phone number: 315-423-7192
Copy
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