East Coast Medical and Wellness LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA08719200 Issued in NJ

Legal business name

EAST COAST MEDICAL AND WELLNESS LLC

Practice address

908 Main Street Suite a
Asbury Park, NJ 07712

Phone

(973) 718-2835

NPI assigned

Sep 1, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Shepherd

Title

Director

Phone

(973) 718-2635

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1114474731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 MAIN STREET SUITE A",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "973-718-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 MAIN STREET SUITE A",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "973-718-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST MEDICAL AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "973-718-2635"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA08719200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deal Lake Medical Associates
• Patricia A Dempsey, APN
• Gargi Dhar, MD
• Mary Dorsi, M.A., CCC-SLP
• Alexandra Dostrel, APN
• Mercedes Echevarria, APN
• Joyce P. Ellis, LCSW
• Em-Power Me
• Albert G Endler, MSN
• Ellen Engel

• Specialist in Asbury Park, NJ
• Providers in Asbury Park, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.