Provider First Line Business Practice Location Address:
201 LYONS AVENUE
Provider Second Line Business Practice Location Address:
A6-HOSPITALIST OFFICE
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-926-2164
Provider Business Practice Location Address Fax Number:
973-391-8524
Provider Enumeration Date:
12/23/2011