Provider First Line Business Practice Location Address:
1650 GRAND CONCOURSE
Provider Second Line Business Practice Location Address:
BRONX LEBANON HOSPITAL CENTER DEPARTMENT OF EMERGENCY M
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10457-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-960-1400
Provider Business Practice Location Address Fax Number:
718-960-2077
Provider Enumeration Date:
11/14/2006