Provider Demographics
NPI:1043743891
Name:WEST COAST HEALTH AND REHAB PC
Entity Type:Organization
Organization Name:WEST COAST HEALTH AND REHAB PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:RENCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-207-9063
Mailing Address - Street 1:PO BOX 22592
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2592
Mailing Address - Country:US
Mailing Address - Phone:702-964-1525
Mailing Address - Fax:
Practice Address - Street 1:103 RIVER RD STE 101
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1016
Practice Address - Country:US
Practice Address - Phone:201-308-8995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-08
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty