Provider First Line Business Practice Location Address:
298 PASSAIC STREET
Provider Second Line Business Practice Location Address:
PASSAIC PEDIATRICS PA
Provider Business Practice Location Address City Name:
PASSAIC
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07055-1009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-249-8100
Provider Business Practice Location Address Fax Number:
973-249-8110
Provider Enumeration Date:
06/25/2014