Provider First Line Business Practice Location Address:
1 ELM ST
Provider Second Line Business Practice Location Address:
PARKWAY PLAZA MEDICAL CENTER
Provider Business Practice Location Address City Name:
TUCKAHOE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-337-0606
Provider Business Practice Location Address Fax Number:
914-337-6780
Provider Enumeration Date:
09/15/2006