Provider First Line Business Practice Location Address:
ATLANTICARE REGIONAL MEDICAL CENTER JIMMIE LEEDS RD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PSYCHIATRY MAINLAND DIVISION
Provider Business Practice Location Address City Name:
POMONA
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-652-3551
Provider Business Practice Location Address Fax Number:
609-404-7686
Provider Enumeration Date:
06/13/2006