Provider First Line Business Practice Location Address:
268 CANAL STREET
Provider Second Line Business Practice Location Address:
CHARLES B. WANG COMMUNITY HEALTH CENTER
Provider Business Practice Location Address City Name:
NY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-379-6999
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2006