Provider First Line Business Practice Location Address:
655 E. JERSEY SREET
Provider Second Line Business Practice Location Address:
TRINITAS REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
ELIZABETH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-994-3105
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2011