Provider First Line Business Practice Location Address: 
333 CEDAR STREET, TOMPKINS 3
    Provider Second Line Business Practice Location Address: 
YUSM DEPARTMENT OF ANESTHESIOLOGY
    Provider Business Practice Location Address City Name: 
NEW HAVEN
    Provider Business Practice Location Address State Name: 
CT
    Provider Business Practice Location Address Postal Code: 
06520-8051
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
203-785-2802
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
06/25/2011