Provider First Line Business Practice Location Address:
3170 BROADWAY
Provider Second Line Business Practice Location Address:
GRANT HOUSES HEALTH CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10027-3341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-678-8420
Provider Business Practice Location Address Fax Number:
212-678-8461
Provider Enumeration Date:
07/19/2006