Provider First Line Business Practice Location Address:
154 UNION AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PATERSON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07502-1849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-942-3618
Provider Business Practice Location Address Fax Number:
973-942-7224
Provider Enumeration Date:
02/08/2012