Provider First Line Business Practice Location Address:
36 NEWARK AVE
Provider Second Line Business Practice Location Address:
STE 120 LIGRESTI DERMATOLOGY ASSOCIATES PA
Provider Business Practice Location Address City Name:
BELLEVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07109-4120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-759-6569
Provider Business Practice Location Address Fax Number:
973-759-2562
Provider Enumeration Date:
09/21/2006