Provider First Line Business Practice Location Address:
MMG - FAMILY HEALTH CENTER
Provider Second Line Business Practice Location Address:
360 EAST 193RD STREET
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-405-4067
Provider Business Practice Location Address Fax Number:
718-405-4148
Provider Enumeration Date:
10/26/2006