Provider First Line Business Practice Location Address:
10 NATHAN D PERLMAN PLACE C/O BEVERLY COOPER
Provider Second Line Business Practice Location Address:
SUITE 12S34 - PATHOLOGY
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-3851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-420-2124
Provider Business Practice Location Address Fax Number:
212-420-3449
Provider Enumeration Date:
07/31/2006