Provider First Line Business Practice Location Address:
400 LAKE AVENUE
Provider Second Line Business Practice Location Address:
VISITING NURSE ASSOCIATION
Provider Business Practice Location Address City Name:
STATIN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-816-3434
Provider Business Practice Location Address Fax Number:
718-816-3534
Provider Enumeration Date:
08/27/2012