Provider First Line Business Practice Location Address:
36-42 JAMES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10940-5765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-344-4433
Provider Business Practice Location Address Fax Number:
845-344-4439
Provider Enumeration Date:
10/24/2025