Provider First Line Business Practice Location Address:
355 GRAND STREET
Provider Second Line Business Practice Location Address:
DEPARTMENT OF MEDICINE 1 EAST
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-915-2431
Provider Business Practice Location Address Fax Number:
201-915-2219
Provider Enumeration Date:
05/03/2022