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Individual
DR. PAUL JOSEPH DECANCQ
Active
Individual
DR. PAUL JOSEPH DECANCQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
014228-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106215FC
PREFERRED CARE
NY
01
—
P010014228
BLUE CHOICE
NY
01
—
PDE760144
BLUECROSS / BLUE SHIELD
NY
Enumeration date
05/31/2006
Last updated
04/24/2012
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