Provider Demographics
NPI:1659723708
Name:DECK, EMILIE MARIE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:EMILIE
Middle Name:MARIE
Last Name:DECK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:EMILIE
Other - Middle Name:MARIE
Other - Last Name:GABAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:6 DROMS RD EXT
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-5304
Mailing Address - Country:US
Mailing Address - Phone:518-795-5985
Mailing Address - Fax:
Practice Address - Street 1:4988 STATE HIGHWAY 30
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7520
Practice Address - Country:US
Practice Address - Phone:518-841-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340869363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily