Provider First Line Business Practice Location Address:
121B WEST 20TH STREET
Provider Second Line Business Practice Location Address:
VILLAGE DIAGNOSTIC & TREATMENT 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:
10011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-337-9290
Provider Business Practice Location Address Fax Number:
212-337-9275
Provider Enumeration Date:
06/10/2008