Provider First Line Business Practice Location Address:
45 W 67TH ST.
Provider Second Line Business Practice Location Address:
DOCTORS OFFICE
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-772-9222
Provider Business Practice Location Address Fax Number:
212-879-7235
Provider Enumeration Date:
04/25/2024