Rachael Theresa Detore

Physician Assistant · Wayne, NJ

Individual Active NPI

NPI number 1982154589

Practice location

342 Hamburg Tpke Ste 202
Wayne, NJ 07470-2166
Phone
(973) 870-0777

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NPI record

NPI
1982154589
Entity type
Individual (Type 1)
Enumeration date
October 6, 2016
Last updated
October 25, 2024
Certified
October 25, 2024
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 25MP00878300 NJ
Athletic Trainer 2255A2300X — —
Student in an Organized Health Care Education/Training Program 390200000X — —

Mailing address

10 Wyckoff Ct
Asbury, NJ 08802-1091
Phone
(908) 537-9794

About Rachael Detore

Rachael Theresa Detore is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 342 Hamburg Tpke Ste 202, Wayne, NJ 07470-2166. The NPI number 1982154589 was assigned on October 6, 2016 and the record was last updated on October 25, 2024.

Rachael Detore lists a license in the registry: #25MP00878300 (NJ) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Rachael Theresa Detore?

The NPI number is 1982154589.

What is the phone number of Rachael Detore?

The phone number listed for the practice location is (973) 870-0777.

Where is Rachael Detore located?

342 Hamburg Tpke Ste 202, Wayne, NJ 07470-2166.

What is the taxonomy code for Rachael Detore?

The primary taxonomy code is 363A00000X – Physician Assistant; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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