Provider First Line Business Practice Location Address:
8789 AVENUE D
Provider Second Line Business Practice Location Address:
RITE AID PHARMACY
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-475-5315
Provider Business Practice Location Address Fax Number:
212-677-5345
Provider Enumeration Date:
12/13/2007