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General NPI Number Information
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NPI Number | 1447800289
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Entity Type | Organization
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Legal Business Name | COAST REHAB NYC, LLC
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 883 AVENUE OF THE AMERICAS FL 3
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City | NEW YORK
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State | NY
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Zip | 10001-3501
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Country | US
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Telephone | 646-828-8880
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Fax | 646-518-0130
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Provider Business Mailing Address
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Address Line | 516 GLENMERE AVE
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City | NEPTUNE
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State | NJ
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Zip | 07753-5611
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Country | US
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Telephone | 412-480-5640
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LUKAS DELORENZO
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Credential | DPT
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Telephone | 412-480-5640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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