Provider First Line Business Practice Location Address:
350 ENGLE STREET, 4 EAST
Provider Second Line Business Practice Location Address:
C/O DEPT OF PSYCHIATRY, ENGLEWOOD HOSP & MEDICAL CTR
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:
201-681-2915
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2007