Organization
COASTAL SPINE AND REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH ANDREW PETRONE D.C. (OWNER)
(732) 974-7500
Entity
Organization
Contact information
Practice address
800 HIGHWAY 71, SEA GIRT, NJ 08750-2800
(732) 974-7500
(732) 974-1802
Mailing address
800 HIGHWAY 71, SEA GIRT, NJ 08750-2800
(732) 974-7500
(732) 974-1802
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346282407
NPI
—
01
—
1386723294
NPI
—
Enumeration date
07/16/2009
Last updated
08/29/2009
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