Provider First Line Business Practice Location Address:
1625 POPLAR ST
Provider Second Line Business Practice Location Address:
RADIOLOGY SUITE#100
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10461-2653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-405-8440
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2007