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Individual

DR. ELYSE M DECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
4101 BELL BLVD, BAYSIDE, NY 11361-2858
(718) 428-6700
Mailing address
911 MIDWAY, WOODMERE, NY 11598-1526
(516) 295-2810

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
006919
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02666815
NY
Enumeration date
05/05/2006
Last updated
10/20/2014
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