Provider Demographics
NPI:1396623245
Name:DEMETRO, ANTHONEY
Entity type:Individual
Prefix:
First Name:ANTHONEY
Middle Name:
Last Name:DEMETRO
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 CONNECTICUT AVE NW FL 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2633
Mailing Address - Country:US
Mailing Address - Phone:202-679-9577
Mailing Address - Fax:
Practice Address - Street 1:1215 CONNECTICUT AVE NW FL 3
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2633
Practice Address - Country:US
Practice Address - Phone:202-679-9577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant