Provider First Line Business Practice Location Address:
11 GETTY AVE, BUILDING 275 (DEPAUL AMBULATORY CENTER)
Provider Second Line Business Practice Location Address:
AUDIOLOGY, B241
Provider Business Practice Location Address City Name:
PATERSON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-754-2945
Provider Business Practice Location Address Fax Number:
973-754-4336
Provider Enumeration Date:
08/01/2011