Provider First Line Business Practice Location Address:
993 PARK AVE
Provider Second Line Business Practice Location Address:
PARK AVENUE MEDICINE & SURGERY
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10028-0921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-505-5063
Provider Business Practice Location Address Fax Number:
329-202-9979
Provider Enumeration Date:
08/17/2008