Provider First Line Business Practice Location Address:
448 W 57TH ST
Provider Second Line Business Practice Location Address:
HEALTH ON 57--GARDEN LEVEL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10019-3055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-502-4566
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/10/2012