Provider First Line Business Practice Location Address:
ST LUKES HOSP 1111 AMSTERDAM AVE
Provider Second Line Business Practice Location Address:
OB GYN CLARK 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:
10025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-523-4472
Provider Business Practice Location Address Fax Number:
212-523-1723
Provider Enumeration Date:
01/18/2007