Provider First Line Business Mailing Address: 
130 W KINGSBRIDGE RD
    Provider Second Line Business Mailing Address: 
DEPT OF CARDIOLOGY,JAMES J. PETERS VA MEDICAL CENTER
    Provider Business Mailing Address City Name: 
BRONX
    Provider Business Mailing Address State Name: 
NY
    Provider Business Mailing Address Postal Code: 
10468-3904
    Provider Business Mailing Address Country Code: 
US
    Provider Business Mailing Address Telephone Number: 
347-622-2529
    Provider Business Mailing Address Fax Number: