Provider First Line Business Practice Location Address:
3415 BAINBRIDGE AVENUE
Provider Second Line Business Practice Location Address:
CHILDREN'S HOSPITAL AT MONTEFIORE
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-741-2450
Provider Business Practice Location Address Fax Number:
718-920-5426
Provider Enumeration Date:
10/31/2006