Provider First Line Business Practice Location Address:
56-45 MAIN ST
Provider Second Line Business Practice Location Address:
NYHQ-PATHOLOGY
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355-4592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-670-1141
Provider Business Practice Location Address Fax Number:
718-661-7745
Provider Enumeration Date:
07/07/2006