Provider First Line Business Practice Location Address:
MONTEFIORE MEDICAL CENTER, 111 EAST 210TH ST.
Provider Second Line Business Practice Location Address:
KLAU 2
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-920-4736
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2007