Provider First Line Business Practice Location Address:
N.Y. MEDICAL COLLEGE METROPOLITAN AFFILIATION
Provider Second Line Business Practice Location Address:
1901 FIRST AVE. ROOM 5 SOUTH 2
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-423-7616
Provider Business Practice Location Address Fax Number:
212-423-8478
Provider Enumeration Date:
12/13/2006