MRS. Holly Detore
NPI #1992577290 in Ronkonkoma, New York
Provider Information
- NPI Number
- 1992577290
- Entity Type
- Individual
- Name
- MRS. Holly Detore
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Enumeration Date
- Oct 30, 2023
- Last Updated
- Oct 30, 2023
Practice Location
- Address
- 624 HAWKINS AVE
- City
- Ronkonkoma
- State
- New York
- ZIP Code
- 11779-2375
- Phone
- (631) 240-3579
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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