Provider First Line Business Practice Location Address:
246 GREENE ST
Provider Second Line Business Practice Location Address:
NYUCN MOBILE HEALTH SERVICES, ROOM 713 W
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-6677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-998-5629
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2007