Provider First Line Business Practice Location Address:
300 2ND AVE.
Provider Second Line Business Practice Location Address:
DEPARTMENT OF RADIOLOGY
Provider Business Practice Location Address City Name:
LONG BRANCH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-923-6806
Provider Business Practice Location Address Fax Number:
732-923-6800
Provider Enumeration Date:
11/08/2012