Provider First Line Business Practice Location Address:
NJSP THIRD AND CASS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-292-9700
Provider Business Practice Location Address Fax Number:
609-656-8076
Provider Enumeration Date:
06/26/2008