Paula Marie Detar

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

1487809968 Issued in NY

Practice address

270 Lake St
Penn Yan, NY 14527-1832

Phone

(315) 536-2601

NPI assigned

Jul 16, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Yates County Chapter Nysarc, Inc

  • Early Intervention Provider Agency
  • Penn Yan, NY
  • NPI 1487809968
  NPD (past)

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1437404449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4681 ITALY HILL RD",
            "city": "BRANCHPORT",
            "state": "NY",
            "postal_code": "144189616",
            "telephone_number": "315-305-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 LAKE ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271832",
            "telephone_number": "315-536-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETAR",
        "first_name": "PAULA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "1487809968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Dailey
• Eleanor Hinds De Witt, MD
• Kaitlin Dehond, PT, DPT
• Kimberly Susan Demay, D.C.
• John T Demetros, D.C.
• Jennifer M Dillon, MS, OTR/L
• Vicki June Dornberger, MA SLP
• Taryn Price Draxler, M.D.
• Mary D. Driesch, MD
• Danielle Dunne, LPC/LMHC

• Early Intervention Provider Agency in Penn Yan, NY
• Providers in Penn Yan, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.