Provider First Line Business Practice Location Address:
OPTUM
Provider Second Line Business Practice Location Address:
1 PENN PLAZA 8TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10119-0002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-850-9065
Provider Business Practice Location Address Fax Number:
718-723-3752
Provider Enumeration Date:
06/06/2010