Provider First Line Business Practice Location Address:
1650 GRAND CONCOURSE - 5TH FLOOR
Provider Second Line Business Practice Location Address:
BRONX LEBANON HOSPITAL, DEPT OF OB/GYN
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-239-8363
Provider Business Practice Location Address Fax Number:
718-239-8360
Provider Enumeration Date:
01/25/2006