Provider First Line Business Practice Location Address: 
43 NEW SCOTLAND AVENUE
    Provider Second Line Business Practice Location Address: 
DEPT. OF NEUROSURGERY
    Provider Business Practice Location Address City Name: 
ALBANY
    Provider Business Practice Location Address State Name: 
NY
    Provider Business Practice Location Address Postal Code: 
12208
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
518-262-6679
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
03/26/2022