Provider First Line Business Practice Location Address:
210 EAST 64TH STREET
Provider Second Line Business Practice Location Address:
4TH FLOOR WECARE CLINIC
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-702-7579
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2007