Provider First Line Business Practice Location Address:
SOUTH BEACH PSYCHIATRIC CENTER 777 SEAVIEW AVENUE
Provider Second Line Business Practice Location Address:
BRIDGEVIEW 5A/B
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-667-2600
Provider Business Practice Location Address Fax Number:
718-667-2613
Provider Enumeration Date:
01/11/2007