National Provider Identifier

Paula Marie Detar

Paula Marie Detar is listed in the NPPES registry with a primary specialty of Early Intervention Provider Agency in Penn Yan, NY and a listed phone number of (315) 536-2601.

NPI 1437404449Penn Yan, NYEarly Intervention Provider Agency

Profile Overview

NPI
1437404449
Provider Type
Individual
Primary Specialty
Early Intervention Provider Agency
Enumeration Date
July 16, 2012
Last Updated
July 16, 2012

Practice Location

  • 270 Lake St
  • Penn Yan, NY 14527-1832

Phone: (315) 536-2601

Mailing Address

  • 4681 Italy Hill RD
  • Branchport, NY 14418-9616

Specialties

  • Early Intervention Provider Agency (252Y00000X)
Full Record
NPI
1437404449
Entity Type
Individual
Last Name
Detar
First Name
Paula
Middle Name
Marie
Mailing Street Address
4681 Italy Hill RD
Mailing City
Branchport
Mailing State
NY
Mailing ZIP Code
14418-9616
Mailing Country
US
Mailing Phone
(315) 305-4012
Practice Street Address
270 Lake St
Practice City
Penn Yan
Practice State
NY
Practice ZIP Code
14527-1832
Practice Country
US
Practice Phone
(315) 536-2601
Enumeration Date
July 16, 2012
Last Updated
July 16, 2012
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Early Intervention Provider Agency (252Y00000X)