Healthcare Provider Details

I. General information

NPI: 1437480266
Provider Name (Legal Business Name): COASTAL PHYSICAL THERAPY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 PARKWAY AVE UNIT 2
EWING NJ
08618-2704
US

IV. Provider business mailing address

795 PARKWAY AVE STE A2
EWING NJ
08618-2704
US

V. Phone/Fax

Practice location:
  • Phone: 862-781-3500
  • Fax: 732-863-1707
Mailing address:
  • Phone: 862-781-3500
  • Fax: 862-781-3501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ABISOYE OLAWALE ARIYO
Title or Position: OWNER
Credential: PT
Phone: 862-781-3500