Healthcare Provider Details

I. General information

NPI: 1063641215
Provider Name (Legal Business Name): KRYSTAL G DECKER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 LYSTRA ROGERS DR
LEWISBURG PA
17837-8807
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 570-523-3290
  • Fax: 570-524-5231
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-851-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT006131
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: