Provider Demographics
NPI:1336771732
Name:COATES, ANTONIO
Entity type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:
Last Name:COATES
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 1:3724 HAYES ST NE APT 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-1713
Mailing Address - Country:US
Mailing Address - Phone:202-492-9479
Mailing Address - Fax:
Practice Address - Street 1:3232 GEORGIA AVE NW APT 617
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3089
Practice Address - Country:US
Practice Address - Phone:202-492-9479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant