Robert E Detor | Port Washington, NY • PECOS Search

Robert E Detor

Social Worker

Behavioral Health & Social Service Providers

35 Hilltop Rd, Port Washington, NY 11050-2725

PECOS Enrollment

Based on the most recent information from CMS, provider Robert E Detor does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1518178128
Provider Type
Individual
Full Name
Detor, Robert E
Title
Mr.
Credential
LCSW

Gender
Male
Sole Proprietor
Yes
Enumeration Date
5/25/2007
Last Updated
7/8/2007

Contact Information

Practice Location

35 Hilltop Rd, Port Washington, NY 11050-2725

Unlisted Fax

Mailing Location

400 Sunrise Hwy, Amityville, NY 11701-2508

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License R020697-1 New York