Provider First Line Business Practice Location Address:
345 CHAMBERS ST
Provider Second Line Business Practice Location Address:
STUYVESANT HIGH SCHOOL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10282-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-312-4938
Provider Business Practice Location Address Fax Number:
212-587-3874
Provider Enumeration Date:
03/29/2012