Provider Demographics
NPI:1831348531
Name:DECUIR, COLLEEN OLEKSIAK
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:OLEKSIAK
Last Name:DECUIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BARSTOW RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2209
Mailing Address - Country:US
Mailing Address - Phone:516-482-7960
Mailing Address - Fax:
Practice Address - Street 1:29 BARSTOW RD
Practice Address - Street 2:SUITE 203
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2209
Practice Address - Country:US
Practice Address - Phone:516-482-7960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000844-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist