Provider First Line Business Practice Location Address:
82-12 151 AVE.
Provider Second Line Business Practice Location Address:
PHYSICIAN'S CHOICE SURGICENTER, INC. SUITE 12
Provider Business Practice Location Address City Name:
HOWARD BEACH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-322-9800
Provider Business Practice Location Address Fax Number:
719-832-3759
Provider Enumeration Date:
03/04/2008