Provider First Line Business Practice Location Address:
462 FIRST AVENUE, ROOM 345A
Provider Second Line Business Practice Location Address:
DEPARTMENT OF EMERGENCY MEDICINE, BELLEVUE HOSPITAL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-465-2119
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2008