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Contact Information

DEMETRIOUS A COLEMAN JR, PTA
225-227 MCWHORTER ST.
NEWARK, NJ07105
 Phone: 973-494-0858
 Fax: 844-857-2827
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for DEMETRIOUS A COLEMAN JR · (Male)

NPI # 1265975684
Status Active
Credentials PTA (Physical Therapist Assistant)
Entity Individual
Enumeration date 12/02/2016
Last updated 11/14/2025 - About 7 months ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 40QB00424900
  • NY License # 012511
  • TN License # PTA0000006080
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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