Individual
SHEARA RENEE COATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31 UNION AVE APT A, NUTLEY, NJ 07110-3325
(862) 218-5390
(862) 252-7381
Mailing address
121 CENTRAL PL APT D205, ORANGE, NJ 07050-3846
(862) 218-5390
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
C60087047959902
NJ
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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