Provider First Line Business Practice Location Address:
255 WILLIAMSON ST
Provider Second Line Business Practice Location Address:
TRINITAS REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
ELIZABETH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07202-3625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-390-0040
Provider Business Practice Location Address Fax Number:
732-390-1856
Provider Enumeration Date:
06/30/2005