Provider First Line Business Practice Location Address:
601 W 168TH ST APT 25
Provider Second Line Business Practice Location Address:
COLUMBIA UNIVERSITY MEDICAL CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032-3708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-305-9282
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2011