Provider Demographics
NPI:1063866788
Name:DECKERT, KAYLI (DO)
Entity Type:Individual
Prefix:
First Name:KAYLI
Middle Name:
Last Name:DECKERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 COAL VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3703
Mailing Address - Country:US
Mailing Address - Phone:412-650-1100
Mailing Address - Fax:412-650-1101
Practice Address - Street 1:565 COAL VALLEY RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3703
Practice Address - Country:US
Practice Address - Phone:412-650-1100
Practice Address - Fax:412-650-1101
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0205792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry