Provider Demographics
NPI:1497264337
Name:ELC REHABILITATION
Entity Type:Organization
Organization Name:ELC REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCASCIO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-838-8883
Mailing Address - Street 1:2 ARROWHEAD TRL
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-3102
Mailing Address - Country:US
Mailing Address - Phone:973-838-8883
Mailing Address - Fax:973-838-8883
Practice Address - Street 1:2 ARROWHEAD TRL
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-3102
Practice Address - Country:US
Practice Address - Phone:973-838-8883
Practice Address - Fax:973-838-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00627500261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy