Provider First Line Business Practice Location Address:
110 PRIMROSE ST.
Provider Second Line Business Practice Location Address:
PRIMROSE ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
LINCOLNDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-248-8888
Provider Business Practice Location Address Fax Number:
914-248-5384
Provider Enumeration Date:
12/04/2012