Individual provider · Type 1 NPI
Carly Detor, NP
Nurse Practitioner · Syracuse, NY
Practice location
104 Union Ave, Suite 1001-1002
Syracuse, NY 13203-1843
Fax (315) 423-8013
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 339796 (NY) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1114303278
Carly Detor, NP's National Provider Identifier is 1114303278, issued on Jul 30, 2015. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Syracuse, NY. The record was last updated on Jul 30, 2015.