Provider First Line Business Practice Location Address:
11 MARSHALL RD
Provider Second Line Business Practice Location Address:
C/O NORTHERN PSYCHIATRIC SERVICES
Provider Business Practice Location Address City Name:
WAPPINGERS FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12590-4132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-715-7032
Provider Business Practice Location Address Fax Number:
203-244-5394
Provider Enumeration Date:
06/27/2007