Provider First Line Business Practice Location Address:
245 E 84TH ST.
Provider Second Line Business Practice Location Address:
GROUND FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-973-5434
Provider Business Practice Location Address Fax Number:
212-379-2122
Provider Enumeration Date:
12/09/2022