Provider First Line Business Practice Location Address:
163 W. 125 ST.
Provider Second Line Business Practice Location Address:
MANHATTAN PSYCHIATRIC CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10027-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-961-8730
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2006