Provider First Line Business Practice Location Address:
435 FORT WASHINGTON AVE
Provider Second Line Business Practice Location Address:
ST FLOOR MEDICAL 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:
10033-3506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-795-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2005