Individual provider · Type 1 NPI

Holly Detore

Specialist · Ronkonkoma, NY

NPI number 1992577290 Active

Practice location

624 Hawkins Ave
Ronkonkoma, NY 11779-2375

Call (631) 240-3579 Map

Mailing address

17 Bourne Blvd
Bohemia, NY 11716-4901

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1992577290

Holly Detore's National Provider Identifier is 1992577290, issued on Oct 30, 2023. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Ronkonkoma, NY. The record was last updated on Oct 30, 2023.