Provider First Line Business Practice Location Address:
230 E. RIDGEWOOD AVE
Provider Second Line Business Practice Location Address:
BERGEN REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
PARAMUS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07652-4142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-207-9557
Provider Business Practice Location Address Fax Number:
201-784-1136
Provider Enumeration Date:
08/09/2006