Provider First Line Business Practice Location Address:
UMDNJ-SHRP
Provider Second Line Business Practice Location Address:
1776 RARITAN ROAD
Provider Business Practice Location Address City Name:
SCOTCH PLAINS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07076
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-889-2460
Provider Business Practice Location Address Fax Number:
908-889-2487
Provider Enumeration Date:
12/19/2012