Provider First Line Business Practice Location Address:
30 PROSPECT AVE
Provider Second Line Business Practice Location Address:
HACKENSACK UNIVERSITY MEDICAL CENTER
Provider Business Practice Location Address City Name:
HACKENSACK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-996-5437
Provider Business Practice Location Address Fax Number:
201-487-7340
Provider Enumeration Date:
08/07/2006