Provider First Line Business Practice Location Address:
5 GRACE CHURCH ST
Provider Second Line Business Practice Location Address:
OPEN DOOR FAMILY MEDICAL CENTERS, INC.
Provider Business Practice Location Address City Name:
PORT CHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10573-4911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-937-8899
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/18/2006