Provider First Line Business Practice Location Address:
ST JOHNS EPISCOPAL HOSPITAL 327 BEACH CHANNEL DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAR ROCKAWAY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11691-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-869-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/04/2005