Individual provider Active NPI

Amanda Marie Detore, PHARMD

  • Pharmacist
  • Rockaway, NJ
National Provider Identifier
1154066041
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP456657 Issued in PA
Practice address
381 Mount Hope Ave
Rockaway, NJ 07866-1645
Phone
(973) 989-7984
NPI assigned
May 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04241200 NJ
Pharmacist 183500000X RP456657 PA Primary

Addresses

Primary practice location

381 Mount Hope Ave
Rockaway, NJ 07866-1645

Mailing address

381 Mount Hope Ave
Rockaway, NJ 07866-1645
Phone (973) 989-7984

Other identifiers 1

IdentifierTypeStateIssuer
28RI04241200OtherLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI04241200NJMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1154066041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 MOUNT HOPE AVE",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078661645",
            "telephone_number": "973-989-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 MOUNT HOPE AVE",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078661645",
            "telephone_number": "973-989-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETORE",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-04",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04241200",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP456657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "28RI04241200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockaway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.