Individual
THOMAS JAY DECKER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 MONTCALM ST, TICONDEROGA, NY 12883-1393
(518) 585-7934
(518) 585-9132
Mailing address
50 MONTCALM ST, TICONDEROGA, NY 12883-1393
(518) 585-7934
(518) 585-9132
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629172762
—
NY
Enumeration date
07/13/2022
Last updated
07/13/2022
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