Provider First Line Business Practice Location Address:
120 W 106TH ST
Provider Second Line Business Practice Location Address:
MEDICAL DEPARTMENT
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10025-3923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-870-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/04/2009