Provider First Line Business Practice Location Address:
60 PROSPECT AVENUE
Provider Second Line Business Practice Location Address:
ORANGE REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-343-6216
Provider Business Practice Location Address Fax Number:
845-343-6228
Provider Enumeration Date:
09/29/2006