Provider Demographics
NPI:1548213192
Name:DEKOYER, NOAH (DC)
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:DEKOYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:NOAH
Other - Middle Name:
Other - Last Name:DEKOYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:734 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4274
Mailing Address - Country:US
Mailing Address - Phone:201-437-0033
Mailing Address - Fax:201-858-4049
Practice Address - Street 1:734 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4274
Practice Address - Country:US
Practice Address - Phone:201-437-0033
Practice Address - Fax:201-858-4049
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00584800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ050645PIUMedicare PIN