Provider Demographics
NPI:1548936883
Name:BEAL, ANTHONY LONNELLE
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LONNELLE
Last Name:BEAL
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 1:2707 AFTON ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1108
Mailing Address - Country:US
Mailing Address - Phone:202-867-2884
Mailing Address - Fax:
Practice Address - Street 1:4642 LIVINGSTON RD SE APT 202
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3146
Practice Address - Country:US
Practice Address - Phone:202-734-2994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant