Provider First Line Business Practice Location Address:
402 E 156TH ST
Provider Second Line Business Practice Location Address:
NURSING OFFICE-3RD FLOOR
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10455-1232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-531-1972
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/29/2010