Provider First Line Business Practice Location Address:
3424 KOSSUTH AVENUE
Provider Second Line Business Practice Location Address:
OPD CLINIC 4B PSYCHIATRY
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:
718-519-3556
Provider Business Practice Location Address Fax Number:
718-519-2497
Provider Enumeration Date:
03/12/2008