Provider First Line Business Practice Location Address:
222 UNION AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PATERSON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-942-7329
Provider Business Practice Location Address Fax Number:
973-942-4647
Provider Enumeration Date:
07/15/2006