Provider First Line Business Practice Location Address:
560 LEXINGTON AVENUE, 12TH FL
Provider Second Line Business Practice Location Address:
NORTHWELL BEHAVIORAL HEALTH
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:
10022-6828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-665-6020
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2015