JOANNE DETORE (NPI# 1396724894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396724894 |
| Entity Type | Individual |
| Full Name | JOANNE DETORE |
| Credential | PA |
| Practice Address |
2 Broad Street Plz Broad Street Medical Group Glens Falls NY 12801-4363 |
| Mailing Address |
Po Box 304 Glens Falls NY 12801-0304 |
| Practice Telephone | 5189261770 |
| Practice Fax Number | 5189261799 |
| Mailing Telephone | 5189261770 |
| Mailing Fax Number | 5189261799 |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2012-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 006825 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02340921 | 05 | |
| NY | RR MEDICARE | P00055451 | 01 |
| Street Address |
2 BROAD STREET PLZ BROAD STREET MEDICAL GROUP |
| City | GLENS FALLS |
| State | NY |
| Zip Code | 12801-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144214503 | Thomas Kandora | Internal Medicine | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2005-08-31 |
| 1376891317 | Glens Falls Hospital Inc | Internal Medicine | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4789 | 2012-08-23 |
| 1518215565 | Glens Falls Hospital Inc | Otolaryngology | 2 Broad Street Plz, Adirondack Ent, Glens Falls, NY 12801-4363 | 2012-08-23 |
| 1144508144 | Elizabeth Hutchins | Nurse Practitioner | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4363 | 2011-07-26 |
| 1255636239 | Catherine Reichen | Physical Therapist | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2011-01-21 |
| 1174828636 | Robert J Collette | Physical Therapist | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2011-01-14 |
| 1407151996 | Laura A Rhodes | Physical Therapist | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2011-01-14 |
| 1669675203 | Raju Sadal | Physician Assistant | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4363 | 2007-06-11 |
| 1417001025 | Sean Michael Kennedy | Otolaryngology | 2 Broad Street Plz, Adirondack Ent, Glens Falls, NY 12801-4363 | 2007-01-22 |
| 1972680288 | Mark H Weidner | Internal Medicine | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4363 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629549399 | Upstate Vision Care, Pllc | Technician/Technologist | 206 Glen St. Suite 31b, Colvin Building, Glens Falls, NY 12801 | 2018-12-06 |
| 1043737356 | Tiffany Britt | Social Worker | 43 Kensington Rd, Glens Falls, NY 12801 | 2017-08-28 |
| 1922375922 | Kathleen A Callaghan | Registered Nurse | 43 Kensington Road, Glens Falls, NY 12801 | 2011-11-19 |
| 1043595531 | Nancy K. Carroll | Social Worker | 37 Broad St., Glens Falls, NY 12801 | 2011-10-15 |
| 1992027528 | Benjamin Alan Rametta | Pharmacist | 202 Broad Street, Walgreens, Glens Falls, NY 12801 | 2010-02-23 |
| 1194052563 | Angela M Lalla | Audiologist | 318 Ridge Street, Glens Sallas, NY 12801 | 2009-11-05 |
| 1407018591 | Marilyn J Bryan | Counselor | 4 Technical Park, Suite #3, #6, Glens Falls, NY 12801 | 2008-06-30 |
| 1104087667 | Chase Chiropractic LLC | Chiropractor | 17 Pine St. 1 Irongate Center, Suite 3, Glens Falls, NY 12801 | 2008-06-18 |
| 1619183571 | Glens Falls Crossings LLC | Skilled Nursing Facility | 170 Warren Street, Glens Falls, NY 12801 | 2007-05-15 |
| 1417099706 | Patricia Ann Cameron | Psychologist | 464 Glen Street, Glens Falls, NY 12801 | 2007-02-13 |
| Find all providers in zip 12801 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730199449 | Kelly Reed | Physician Assistant | 1 Southwestern Ave, Glens Falls, NY 12801-4390 | 2006-08-08 |
| 1871500165 | Jacquelyn Buckley | Physician Assistant | 154 Warren Street, Glens Falls, NY 12801 | 2006-08-01 |
| 1568486694 | Rebecca Broadaway | Physician Assistant | Glens Falls Hospital Ecc, 100 Park Ave, Glens Falls, NY 12801 | 2006-07-26 |
| 1114960580 | Magdeline Inzerilli | Physician Assistant | 100 Broad St, Glens Falls, NY 12801-4349 | 2006-06-14 |
| 1225007347 | Jeannelle M Shaver | Physician Assistant | 102 Park Street Pryun Pavilioin At Glens Falls Hospital, The Vascular Group Pllc, Glens Falls, NY 12801 | 2006-03-14 |
| 1972101178 | Marissa Elaine Chaffee | Physician Assistant | 3 Irongate Ctr, Glens Falls, NY 12801-3471 | 2020-10-12 |
| 1730744608 | Danielle Marie Tetreault | Physician Assistant | 100 Broad St, Glens Falls, NY 12801-4349 | 2019-05-07 |
| 1043796816 | Melody K Long | Physician Assistant | 100 Park St, Glens Falls, NY 12801-4447 | 2018-07-16 |
| 1861978710 | Aaron B Heckler | Physician Assistant | 100 Park St, Glens Falls, NY 12801-4413 | 2018-07-13 |
| 1023505880 | Evan Markessinis | Physician Assistant | 100 Park St, Glens Falls, NY 12801-4447 | 2018-04-17 |
| Find all providers in GLENS FALLS | ||||
| City | GLENS FALLS |
| Zip Code | 12801 |
Please comment or provide details below to improve the information on JOANNE DETORE.
| 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.