Provider First Line Business Practice Location Address:
ADULT MEDICINE PRACTICE
Provider Second Line Business Practice Location Address:
3444 KOSSUTH AVENUE, 5TH FL.
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-920-5905
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/13/2006