Provider First Line Business Practice Location Address:
3400 BAINBRIDGE AVE
Provider Second Line Business Practice Location Address:
4TH FLOOR/ GENERAL SURGERY
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467-2404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-920-8178
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/18/2011