Provider First Line Business Practice Location Address:
COLUMBIA UNIVERSITY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
622 W. 168TH ST., VANDERBILT CLINIC, 10TH FL, ROOM 1001
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-305-2531
Provider Business Practice Location Address Fax Number:
212-342-2112
Provider Enumeration Date:
01/18/2007