Provider First Line Business Practice Location Address:
RT 9D
Provider Second Line Business Practice Location Address:
DEPARTMENT OF VETERANS AFFAIRS, CASTLE POINT CAMPUS
Provider Business Practice Location Address City Name:
CASTLE POINT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-838-5226
Provider Business Practice Location Address Fax Number:
845-838-5266
Provider Enumeration Date:
07/31/2006