MEDICARE: SAND COAST REHAB PHYSICAL THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	225X00000X	Occupational Therapist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1639766603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAND COAST REHAB PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	436 CHESTNUT ST UNIT 1
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5811
Country	:	US
Telephone Number	:	732-994-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	436 CHESTNUT ST UNIT 1
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5811
Country	:	US
Telephone Number	:	732-994-3200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ELIEZER FRIEDMAN
Credential	:
Telephone Number	:	732-886-6202

Provider Enumeration Date	:	12/24/2020
Last Update Date	:	12/25/2024

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Directions to “SAND COAST REHAB PHYSICAL THERAPY INC ” Practice Location

Language	Start Address	Practice Location

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