Provider First Line Business Practice Location Address:
113 HOLLAND AVENUE, MAIL CODE 111-D
Provider Second Line Business Practice Location Address:
STRATTON VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-626-6487
Provider Business Practice Location Address Fax Number:
518-626-6606
Provider Enumeration Date:
10/04/2005