Basic Information
| Provider Information | |||||||||
| NPI: | 1306119433 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DECKER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | EDWARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 127 OLIVERA WAY | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334186209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616942021 | ||||||||
| FaxNumber: | 5163548597 | ||||||||
| Practice Location | |||||||||
| Address1: | 127 OLIVERA WAY | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334186209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616942021 | ||||||||
| FaxNumber: | 5163548597 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2012 | ||||||||
| LastUpdateDate: | 02/21/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 092470-1 | NY | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.