Individual
JOSEPHINE DETAR
Active
Individual
JOSEPHINE DETAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1867691
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018396300001
—
PA
01
—
008130315
BCBS
NY
05
—
01390312
—
NY
01
—
050084782
RR MEDICARE
NY
01
—
610421800
DEPT OF LABOR
NY
Enumeration date
05/16/2006
Last updated
06/14/2008
Update your record
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