Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Nov 3, 2006
License(s)
MA056951 (NJ)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 633 3RD AVE BOX 3 | New York, NY 10017-6706 | |
| LOCATION | 136 MOUNTAIN VIEW BLVD | Basking Ridge, NJ 07920 | 908-542-3200 |
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