Provider First Line Business Practice Location Address:
60 JEFFERSON ST STE 5
Provider Second Line Business Practice Location Address:
JAYINS I CORP (ARUMUGAM JAYARAJ, MD.)
Provider Business Practice Location Address City Name:
MONTICELLO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12701-1131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-790-2667
Provider Business Practice Location Address Fax Number:
845-790-2675
Provider Enumeration Date:
02/12/2009