Provider First Line Business Practice Location Address:
703 MAIN ST
Provider Second Line Business Practice Location Address:
ST. JOSEPHS CHILDRENS HOSPITAL
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:
917-757-3086
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006