Provider Demographics
NPI:1689728693
Name:COATE, ANDREW DAVID (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:DAVID
Last Name:COATE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 OAK CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1025
Mailing Address - Country:US
Mailing Address - Phone:973-377-8945
Mailing Address - Fax:
Practice Address - Street 1:66 MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1813
Practice Address - Country:US
Practice Address - Phone:973-377-0075
Practice Address - Fax:973-377-1960
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02589100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist