Provider First Line Business Practice Location Address:
3415 BAINBRIDGE AVE.
Provider Second Line Business Practice Location Address:
CHILDREN'S HOSPITAL OF MONTEFIORE
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-741-2055
Provider Business Practice Location Address Fax Number:
718-741-2033
Provider Enumeration Date:
05/11/2007