Individual
EVAN DECKELBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1111 CLIFTON AVE, CLIFTON, NJ 07013-3633
(973) 400-3730
Mailing address
109 RAAB AVE, BLOOMFIELD, NJ 07003-4520
(410) 382-4644
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
031521
NY
225100000X
Physical Therapist
Primary
40QA01592700
NJ
Other
Enumeration date
09/18/2008
Last updated
03/24/2015
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