Provider Demographics
NPI:1427751551
Name:COLEMAN, BERNARDO
Entity type:Individual
Prefix:
First Name:BERNARDO
Middle Name:
Last Name:COLEMAN
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 1:4221 E CAPITOL ST SE APT 40
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-4477
Mailing Address - Country:US
Mailing Address - Phone:202-749-1541
Mailing Address - Fax:
Practice Address - Street 1:4221 E CAPITOL ST SE APT 40
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-4477
Practice Address - Country:US
Practice Address - Phone:202-749-1541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant