Provider First Line Business Practice Location Address:
234 E 149TH ST
Provider Second Line Business Practice Location Address:
LINCOLN HOSPITAL - UTILIZATION MANAGEMENT ROOM 7-36
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10451-5504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-579-5176
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/01/2010