Provider First Line Business Practice Location Address: 
2094 ALBANY POST RD
    Provider Second Line Business Practice Location Address: 
VA HUDSON VALLEY HEALTH CARE SYSTEM
    Provider Business Practice Location Address City Name: 
MONTROSE
    Provider Business Practice Location Address State Name: 
NY
    Provider Business Practice Location Address Postal Code: 
10548
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
914-737-4400
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
10/05/2006