Healthcare Provider Details

I. General information

NPI: 1063325876
Provider Name (Legal Business Name): EAST COAST REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 EDWARD L GRANT HWY
BRONX NY
10452-3144
US

IV. Provider business mailing address

1308 EDWARD L GRANT HWY
BRONX NY
10452-3144
US

V. Phone/Fax

Practice location:
  • Phone: 718-538-8343
  • Fax: 718-538-8356
Mailing address:
  • Phone: 718-538-8343
  • Fax: 718-538-8356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEONID FUTERMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 718-538-8343