Provider First Line Business Practice Location Address:
34 24 KOSSUTH AVENUE 4B
Provider Second Line Business Practice Location Address:
NORTH CENTRAL BRONX HOSP AOPD
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:
718-519-3440
Provider Business Practice Location Address Fax Number:
718-519-2497
Provider Enumeration Date:
02/26/2007