Provider First Line Business Practice Location Address:
BRONX - LEBANON HOSPITAL CENTER. 1650 GRAND CONCOURSE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-960-1234
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2022