Provider First Line Business Practice Location Address:
1650 GRAND CONCOURSE
Provider Second Line Business Practice Location Address:
DEPT OF EMERGENCY MEDICINE
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
10456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-518-5046
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2007