Provider First Line Business Practice Location Address:
130 WEST KINGBRIDGE ROAD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF VETERAN AFFAIRS, VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10468-3627
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
171-858-4900
Provider Business Practice Location Address Fax Number:
718-741-4615
Provider Enumeration Date:
02/23/2016