Provider First Line Business Practice Location Address:
2520 KENNEDY BOULEVARD
Provider Second Line Business Practice Location Address:
GROUND FLOOR - SOUTH SIDE
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07304-2054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-333-3088
Provider Business Practice Location Address Fax Number:
201-333-7616
Provider Enumeration Date:
01/04/2007