Provider First Line Business Practice Location Address:
535 GETTY AVE
Provider Second Line Business Practice Location Address:
SUITE-3(PARK AVE MEDICAL CENTER)
Provider Business Practice Location Address City Name:
CLIFTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07011-2105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-782-4905
Provider Business Practice Location Address Fax Number:
973-782-4893
Provider Enumeration Date:
12/04/2009