Provider First Line Business Practice Location Address:
300 COMMUNITY DR
Provider Second Line Business Practice Location Address:
NORTH SHORE UNIVERSITY HOSPITAL, NP / PA OFFICE 1 TOWER
Provider Business Practice Location Address City Name:
MANHASSET
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11030-3816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-562-3603
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2011