Individual
KELLY ELYSE DETOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
STONY BROOK UNIVERSITY HOSPITAL, 101 NICOLLS ROAD, STONY BROOK, NY 11794-0001
(631) 444-4000
Mailing address
101 NICOLLS ROAD, STONY BROOK UNIVERSITY HOSPITAL, STONY BROOK, NY 11794
(631) 444-4000
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD466262
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2013
Last updated
03/11/2019
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