Provider First Line Business Practice Location Address:
207 VASSAR AVE
Provider Second Line Business Practice Location Address:
FIRST FLOOR, RIGHT
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07112-1727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-926-1850
Provider Business Practice Location Address Fax Number:
973-926-0512
Provider Enumeration Date:
03/31/2008