Provider Demographics
NPI:1568495174
Name:DECKLER, STEVEN R (DC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:R
Last Name:DECKLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 FISCHER BLVD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3844
Mailing Address - Country:US
Mailing Address - Phone:732-270-1208
Mailing Address - Fax:732-270-8432
Practice Address - Street 1:972 FISCHER BLVD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3844
Practice Address - Country:US
Practice Address - Phone:732-270-1208
Practice Address - Fax:732-270-8432
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00232100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3375102Medicaid
NJP808727OtherOXFORD
NJ468918Medicare ID - Type Unspecified
NJ3375102Medicaid