Provider First Line Business Practice Location Address:
240 SPRAGUE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH PLAINFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07080-5555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-565-1341
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/27/2026