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General NPI Number Information
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NPI Number | 1760691653
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Entity Type | Individual
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Provider Name | STEPHEN MICHAEL DECKER PT
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 83 FRANKLIN TPKE
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City | WALDWICK
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State | NJ
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Zip | 07463-1820
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Country | US
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Telephone | 201-445-1079
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Fax | 201-445-1315
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Provider Business Mailing Address
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Address Line | 185 COTTAGE RD
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City | WYCKOFF
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State | NJ
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Zip | 07481-2506
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Country | US
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Telephone | 201-652-4582
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT40QA00995800
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License Number State | NJ
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