Provider Demographics
NPI:1598205478
Name:WEST COAST HEALTH AND REHABILITATION LLC
Entity Type:Organization
Organization Name:WEST COAST HEALTH AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NITIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PUTCHA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-972-3618
Mailing Address - Street 1:103 RIVER RD
Mailing Address - Street 2:STE 101
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1016
Mailing Address - Country:US
Mailing Address - Phone:917-972-3618
Mailing Address - Fax:
Practice Address - Street 1:103 RIVER RD
Practice Address - Street 2:STE 101
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1016
Practice Address - Country:US
Practice Address - Phone:917-972-3618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty