Provider First Line Business Practice Location Address:
24 IDLEWILD AVENUE
Provider Second Line Business Practice Location Address:
CORNWALL CENTRAL SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
CORNWALL-ON-HUDSON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-534-8009
Provider Business Practice Location Address Fax Number:
845-534-0569
Provider Enumeration Date:
10/26/2015