Provider First Line Business Practice Location Address:
21 W 86TH ST
Provider Second Line Business Practice Location Address:
COLUMBIA.WEST SIDE PEDIATRICS
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10024-3616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-799-2737
Provider Business Practice Location Address Fax Number:
212-799-8150
Provider Enumeration Date:
01/11/2006