Provider First Line Business Practice Location Address:
234 E 149 STREET
Provider Second Line Business Practice Location Address:
7B - ADULT OUTPATIENT PSYCHIATRY
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-579-5893
Provider Business Practice Location Address Fax Number:
718-579-5045
Provider Enumeration Date:
01/15/2020