Provider Demographics
NPI:1942552526
Name:TATE, RAYMOND LAMONT
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:LAMONT
Last Name:TATE
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 1:1543 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1960
Mailing Address - Country:US
Mailing Address - Phone:202-907-2480
Mailing Address - Fax:
Practice Address - Street 1:1543 3RD ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1960
Practice Address - Country:US
Practice Address - Phone:202-907-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide