Organization Name: | DPMDECKERPRCT, LLC |
NPI Number: | 1386922151 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER R DECKER (OWNER/PODIATRIST) |
Mailing Address: | 300 Hebron Ave Suite 211 Glastonbury |
State: | CT US |
Postal Code: | 060332176 |
Phone Number: | 8606573668 |
Fax Number: | 8606571678 |
NPI Enumeration Date: | 07/28/2011 |
NPI Last Update Date: | 07/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 000853 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |