Provider First Line Business Practice Location Address:
1092 MADISON AVE
Provider Second Line Business Practice Location Address:
ST. PETER'S HEALTH CARE FOR CHILDREN
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12208-2248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-525-2445
Provider Business Practice Location Address Fax Number:
518-475-7069
Provider Enumeration Date:
06/30/2005