Provider First Line Business Practice Location Address:
1ST AVENUE AT 16TH STREET - BETH ISRAEL MEDICAL CENTER
Provider Second Line Business Practice Location Address:
BERNSTEIN PAVILLION - 2ND FLOOR - ROOM 40
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-420-4428
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/14/2008