Provider First Line Business Practice Location Address:
82-68 164TH ST, JAMAICA,NY
Provider Second Line Business Practice Location Address:
QUEENS HOSPITAL CENTER
Provider Business Practice Location Address City Name:
QUEENS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11432-2929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-883-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2020