Provider First Line Business Practice Location Address:
NYPH, 180 FORT WASHINGTON AVENUE
Provider Second Line Business Practice Location Address:
HARKNESS PAVILION - 6TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-305-4405
Provider Business Practice Location Address Fax Number:
212-305-7692
Provider Enumeration Date:
03/26/2007