Provider First Line Business Practice Location Address:
1 E NEW YORK AVE
Provider Second Line Business Practice Location Address:
SHORE MEMEORIAL HOSPITAL
Provider Business Practice Location Address City Name:
SOMERS POINT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-653-3159
Provider Business Practice Location Address Fax Number:
610-617-6280
Provider Enumeration Date:
03/30/2006