Provider First Line Business Practice Location Address:
36 E 36TH ST PH A
Provider Second Line Business Practice Location Address:
THE NEW YORK OTOLARYNGOLOGY GROUP
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-3453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-889-8575
Provider Business Practice Location Address Fax Number:
212-686-3292
Provider Enumeration Date:
05/14/2008