Provider First Line Business Practice Location Address:
2432 GRAND CONCOURSE
Provider Second Line Business Practice Location Address:
POE CLINIC
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-579-7337
Provider Business Practice Location Address Fax Number:
718-817-7904
Provider Enumeration Date:
10/31/2006