MEDICARE: DR. JOSEPH ANTHONY DECORSO JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MA04827400	NJ

General Provider Information

NPI Number	:	1023176682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH ANTHONY DECORSO JR. MD

Provider Business Mailing Address
First Line	:	20 MONTREAL CT
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08757-4121
Country	:	US
Telephone Number	:	973-699-1830
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 MONTREAL CT
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08757-4121
Country	:	US
Telephone Number	:	973-699-1830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	01/09/2018

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