Provider Demographics
NPI:1437480266
Name:COASTAL PHYSICAL THERAPY CENTER LLC
Entity type:Organization
Organization Name:COASTAL PHYSICAL THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABISOYE
Authorized Official - Middle Name:OLAWALE
Authorized Official - Last Name:ARIYO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:862-781-3500
Mailing Address - Street 1:795 PARKWAY AVE STE A2
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2704
Mailing Address - Country:US
Mailing Address - Phone:862-781-3500
Mailing Address - Fax:862-781-3501
Practice Address - Street 1:795 PARKWAY AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2704
Practice Address - Country:US
Practice Address - Phone:862-781-3500
Practice Address - Fax:732-863-1707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty