Provider First Line Business Practice Location Address:
57 BAY STREET
Provider Second Line Business Practice Location Address:
BAY STREET HEALTH CENTER
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10301-2510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-681-8700
Provider Business Practice Location Address Fax Number:
718-442-1521
Provider Enumeration Date:
09/10/2018