Provider First Line Business Practice Location Address:
1225 GERARD AVENUE
Provider Second Line Business Practice Location Address:
MORRISANIA DIAGNOSTIC TREATMENT CENTER
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-960-2201
Provider Business Practice Location Address Fax Number:
718-960-2638
Provider Enumeration Date:
11/29/2007