Provider First Line Business Practice Location Address:
230 E RIDGEWOOD
Provider Second Line Business Practice Location Address:
BERGEN REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
PARAMUS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-967-4151
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/30/2012