Organization
BRUCE A. DECOTIIS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE A DECOTIIS M.D. (PRESIDENT)
(732) 458-2000
Entity
Organization
Contact information
Practice address
1673 ROUTE 88, BRICK, NJ 08724-3050
(732) 458-2000
(732) 458-4523
Mailing address
1673 ROUTE 88 W, BRICK, NJ 08724-3050
(732) 458-2000
(732) 458-4523
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3072703
—
NJ
Enumeration date
11/01/2006
Last updated
12/28/2007
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