Provider Demographics
NPI:1801880695
Name:DECKER, RAYMOND G JR (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:G
Last Name:DECKER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 INDUSTRIAL WAY W
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2265
Mailing Address - Country:US
Mailing Address - Phone:732-542-4477
Mailing Address - Fax:732-935-0355
Practice Address - Street 1:2 INDUSTRIAL WAY W
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-2265
Practice Address - Country:US
Practice Address - Phone:732-542-4477
Practice Address - Fax:732-935-0355
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04697300207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2371707Medicaid
508678N6QMedicare ID - Type Unspecified
E55118Medicare UPIN