Provider Demographics
NPI:1932157781
Name:COASTAL ORTHOPEDICS & ASSOCIATES PC
Entity Type:Organization
Organization Name:COASTAL ORTHOPEDICS & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:MANNAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-862-0462
Mailing Address - Street 1:297 NORTH ST
Mailing Address - Street 2:STE 6A
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5108
Mailing Address - Country:US
Mailing Address - Phone:508-862-0462
Mailing Address - Fax:508-862-0462
Practice Address - Street 1:297 NORTH ST
Practice Address - Street 2:STE 6A
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5108
Practice Address - Country:US
Practice Address - Phone:508-862-0462
Practice Address - Fax:508-862-0462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty