Provider First Line Business Practice Location Address:
IDRISS DERMATOLOGY
Provider Second Line Business Practice Location Address:
80 W 40TH ST, 3RD 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:
10018-2682
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-612-1520
Provider Business Practice Location Address Fax Number:
332-216-3520
Provider Enumeration Date:
05/13/2009