Provider First Line Business Practice Location Address:
234 EUGENIO MARIA DE HOSTOS BLVD, LINCOLN MEDICAL CENTE
Provider Second Line Business Practice Location Address:
ATTEN: AMBULATORY CARE ADMINISTRATION 2ND FLOOR ANNEX
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-579-5640
Provider Business Practice Location Address Fax Number:
718-579-4799
Provider Enumeration Date:
03/08/2006