Provider First Line Business Practice Location Address:
395 GRAND ST
Provider Second Line Business Practice Location Address:
JERSEY CITY MEDICAL CENTER ACC BUILDING 3RD FLOOR
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07302-4238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-521-5934
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/05/2016