Provider First Line Business Practice Location Address:
10 UNION SQUARE EAST, SUITE 2B
Provider Second Line Business Practice Location Address:
BETH ISRAEL HOSPITAL - PHILLIPS AMBULATORY CARE CENTER
Provider Business Practice Location Address City Name:
NEW YORK CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-844-8602
Provider Business Practice Location Address Fax Number:
212-844-8501
Provider Enumeration Date:
02/13/2007