Provider First Line Business Practice Location Address:
CREEDMOOR PSYCHIATRIC CENTER
Provider Second Line Business Practice Location Address:
79-25 WINCHESTER BLVD.
Provider Business Practice Location Address City Name:
QUEENS VILLAGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11427-2199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-264-5450
Provider Business Practice Location Address Fax Number:
718-264-5100
Provider Enumeration Date:
02/12/2019