Provider First Line Business Practice Location Address:
27TH STREET AND FIRST AVE BELLEVUE
Provider Second Line Business Practice Location Address:
HOSPITAL CENTER
Provider Business Practice Location Address City Name:
NEW YORK CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-562-3019
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2006