Provider First Line Business Practice Location Address:
350 ENGLE STREET - 2 EAST (FLOOR)
Provider Second Line Business Practice Location Address:
C/O ENGLEWOOD HOSPITAL AND MEDICAL CENTER
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-569-1107
Provider Business Practice Location Address Fax Number:
201-569-1108
Provider Enumeration Date:
12/23/2013