Provider First Line Business Practice Location Address:
227 MADISON ST
Provider Second Line Business Practice Location Address:
GOUVERNEUR HEALTH SKILLED NURSING FACILITY
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10002-7537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-238-7614
Provider Business Practice Location Address Fax Number:
212-238-7009
Provider Enumeration Date:
06/13/2011