Provider First Line Business Practice Location Address:
111 EAST 210TH STREET
Provider Second Line Business Practice Location Address:
MMC - EMERGENCY MEDICINE
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467-2490
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-920-5406
Provider Business Practice Location Address Fax Number:
718-920-2435
Provider Enumeration Date:
11/08/2006