Provider First Line Business Practice Location Address:
48 IOWA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE HOPATCONG
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07849-1646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-479-8738
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/29/2025