Provider First Line Business Practice Location Address:
83 ZABRISKIE ST
Provider Second Line Business Practice Location Address:
BASEMENT
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07307-3711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-539-6077
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/13/2012