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Delmar Center For Rehabilitation And Nursing

125 Rockefeller Road • Delmar, NY 12054

Personal Information

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Address

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Transaction Details

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Description

Repeated Payments

Ongoing 2 Months 3 Months 4 Months 5 Months 6 Months 8 Months 10 Months 12 Months 18 Months 24 Months 36 Months

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Delmar Center For Rehabilitation And Nursing

125 Rockefeller Road
Delmar, NY 12054

Tell: (518) 621-1200

[response]

ID #[transid]

[created]

[cardholder]

[amount]

[cardtype]   [ccnum4]

Authorization Number

[authcode]

AVS Response

[avsresult]

CVV response

[cvcresult]

Thank you for your payment.