Provider First Line Business Practice Location Address:
4141 CARPENTER AVE
Provider Second Line Business Practice Location Address:
RENAL UNIT
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10466-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-920-9041
Provider Business Practice Location Address Fax Number:
914-633-5084
Provider Enumeration Date:
11/15/2006