Provider First Line Business Practice Location Address:
1250 WATERS PLACE
Provider Second Line Business Practice Location Address:
TOWER II, 7TH FLOOR, VASCULAR SURGERY DEPARTMENT
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
929-263-3741
Provider Business Practice Location Address Fax Number:
929-263-3948
Provider Enumeration Date:
06/09/2012