Provider First Line Business Practice Location Address:
130 EAST 77TH STREET
Provider Second Line Business Practice Location Address:
DEPT. OF NEUROSURGERY, BLACK HALL, THIRD FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-434-3900
Provider Business Practice Location Address Fax Number:
212-434-3899
Provider Enumeration Date:
05/07/2008