| Organization Name: | EAST COAST REHABILITATION SERVICES LLC |
| NPI Number: | 1417228917 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARIA NISPEROS (CO-OWNER) |
| Mailing Address: | 700 Fairfield Ave Kenilworth |
| State: | NJ US |
| Postal Code: | 070332012 |
| Phone Number: | 9082418591 |
| Fax Number: | 8556314348 |
| NPI Enumeration Date: | 01/16/2012 |
| NPI Last Update Date: | 05/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 40QA01110500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |