Provider First Line Business Practice Location Address:
3764 72ND STREET
Provider Second Line Business Practice Location Address:
QUEENS COUNTY NEUROPSYCHIATRIC INST
Provider Business Practice Location Address City Name:
JACKSON HEIGHTS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11372-6143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-335-3434
Provider Business Practice Location Address Fax Number:
718-335-4731
Provider Enumeration Date:
02/13/2007