Provider Demographics
NPI:1104538016
Name:ATEH, NAPHTALY
Entity type:Individual
Prefix:
First Name:NAPHTALY
Middle Name:
Last Name:ATEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2366 VERMONT AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3358
Mailing Address - Country:US
Mailing Address - Phone:202-744-1633
Mailing Address - Fax:
Practice Address - Street 1:2366 VERMONT AVE APT 101
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-3358
Practice Address - Country:US
Practice Address - Phone:202-744-1633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-22
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health