Provider First Line Business Practice Location Address:
535 W 116TH ST.
Provider Second Line Business Practice Location Address:
COLUMBIA UNIVERSITY
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-342-3884
Provider Business Practice Location Address Fax Number:
212-947-7625
Provider Enumeration Date:
10/19/2012