Provider Demographics
NPI:1174609960
Name:EAST COAST MEDICAL
Entity type:Organization
Organization Name:EAST COAST MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-901-2162
Mailing Address - Street 1:483 RIVER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4720
Mailing Address - Country:US
Mailing Address - Phone:732-901-2162
Mailing Address - Fax:732-901-2163
Practice Address - Street 1:483 RIVER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4720
Practice Address - Country:US
Practice Address - Phone:732-901-2162
Practice Address - Fax:732-901-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5834900001Medicare NSC