CARLY DETOR (NPI# 1114303278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114303278 |
| Entity Type | Individual |
| Full Name | CARLY DETOR |
| Credential | NP |
| Practice Address |
104 Union Ave Suite 1001-1002 Syracuse NY 13203-1843 |
| Practice Telephone | 3154237192 |
| Practice Fax Number | 3154238013 |
| Mailing Telephone | 3154237192 |
| Mailing Fax Number | 3154238013 |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2015-07-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 339796 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
104 UNION AVE SUITE 1001-1002 |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13203-1843 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467456350 | Zhandong Zhou | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 104 Union Ave, Ste 1001-1002, Syracuse, NY 13203 | 2005-06-08 |
| 1609237304 | St Joseph's Medical PC | Surgery | 104 Union Ave, Ste 1005, Syracuse, NY 13203-1843 | 2016-03-09 |
| 1306205034 | St. Joseph's Medical PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 104 Union Ave, Ste 1001-1002, Syracuse, NY 13203-1843 | 2016-02-23 |
| 1336491786 | Marianne Christine Malecki | Physician Assistant | 104 Union Ave, Suite 809, Syracuse, NY 13203-1843 | 2012-10-10 |
| 1902095086 | Samuel S. Badalian Md PC | Obstetrics & Gynecology | 104 Union Ave, Suite 803, Syracuse, NY 13203-0000 | 2007-10-15 |
| 1063540060 | Emily Elizabeth Lopez | Physician Assistant | 104 Union Ave, Suite 1005, Syracuse, NY 13203-1843 | 2007-03-01 |
| 1669547915 | Vascular Surgeons of Central New York, Pllc | Specialist | 104 Union Ave, Ste 1005, Syracuse, NY 13203-1843 | 2006-11-22 |
| 1033289137 | Robert E Carlin | Surgery | 104 Union Ave, #1005, Syracuse, NY 13203 | 2006-11-08 |
| 1861561953 | Lawrence Semel | Surgery | 104 Union Ave, #1005, Syracuse, NY 13203 | 2006-11-06 |
| 1881773307 | Mark A Mcgurrin | Surgery | 104 Union Ave, #1005, Syracuse, NY 13203 | 2006-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998193 | Allison Elizabeth Mills | Social Worker | 1045 James St., Syracuse, NY 13203 | 2020-07-01 |
| 1467004333 | Humanitarian Organization for Multicultural Experiences, Inc. | Psychologist | 831 James Street, Syracuse, NY 13203 | 2019-07-11 |
| 1215405287 | Wellness Therapy Services Lcsw, Pllc | Counselor | Wellness Therapy Services Lcsw, Pllc, 404 Oak St. #200, Syracuse, NY 13203 | 2018-11-08 |
| 1962904912 | Michael Musante | Developmental Therapist | 1045 James Streret, Syracuse, NY 13203 | 2018-03-06 |
| 1811410236 | Lindsey Deborah Sanborn | Nurse Practitioner | 301 Prospect Avenue St. Josephs's Hospital Health Cente, Syracuse, NY 13203 | 2017-07-18 |
| 1497205975 | Phuong Pham | Counselor | 329 North Salina Street, Syracuse, NY 13203 | 2016-10-10 |
| 1942754015 | Shelly Lynn Peters | Nurse Practitioner | 329 N. Salina Street, Helio Health, Syracuse, NY 13203 | 2016-08-06 |
| 1932574217 | Kaleigh Marie Andino | Audiologist | 1001 James Street, Syracuse, NY 13203 | 2015-12-11 |
| 1376889493 | Brenda S Hartman-souder | Social Worker | 526 Oak St., Syracuse, NY 13203 | 2012-12-18 |
| 1386914711 | Steven W Dimarzo | Counselor | 404 Oak St Ste 320, Syracuse, NY 13203 | 2012-01-02 |
| Find all providers in zip 13203 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | 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 with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639730690 | Michelle L Lane | Nurse Practitioner | 301 Prospect Ave Fl 6, Syracuse, NY 13203-1807 | 2019-06-21 |
| 1942754015 | Shelly Lynn Peters | Nurse Practitioner | 329 N. Salina Street, Helio Health, Syracuse, NY 13203 | 2016-08-06 |
| 1205241411 | Erin M. Kreifels | Nurse Practitioner | 277 E 17th St, Syracuse, NE 68446-5000 | 2014-06-25 |
| 1174675995 | Michelle Anne Dart | Nurse Practitioner | 3229 E. Genesee St., Syracuse, NY 13214 | 2007-01-18 |
| 1750470738 | Anna Marie Santoro | Nurse Practitioner | 800 Irving Ave Rm A202, Syracuse, NY 13210-2716 | 2006-10-11 |
| 1578582128 | Sean M Murphy | Nurse Practitioner | 144 Century Dr, Syracuse, NY 13209-2204 | 2006-07-18 |
| 1356304638 | Dana L Karash | Nurse Practitioner | 1120 E Genesee St, Syracuse, NY 13210-1912 | 2006-04-08 |
| 1679547392 | Jeanne E Pietrzak | Nurse Practitioner | 739 Irving Ave Ste 500, Syracuse, NY 13210-1664 | 2006-02-17 |
| 1073129029 | Kaitlyn Hazelmyer | Nurse Practitioner | 736 Irving Ave, Syracuse, NY 13210-1687 | 2020-09-16 |
| 1689299505 | Kimberly Ann Cerasani | Nurse Practitioner | 90 Presidential Plz, Syracuse, NY 13202-2240 | 2020-06-16 |
| Find all providers in SYRACUSE | ||||
Please comment or provide details below to improve the information on CARLY DETOR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.