Provider Demographics
NPI:1154798361
Name:COLEMAN, METTE
Entity type:Individual
Prefix:
First Name:METTE
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6423 MONTGOMERY ST
Mailing Address - Street 2:SUITE 17A
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1362
Mailing Address - Country:US
Mailing Address - Phone:845-876-7683
Mailing Address - Fax:845-876-3220
Practice Address - Street 1:6423 MONTGOMERY ST
Practice Address - Street 2:SUITE 17A
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1362
Practice Address - Country:US
Practice Address - Phone:845-876-7683
Practice Address - Fax:845-876-3220
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01637012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic