Provider First Line Business Practice Location Address:
111 E 210TH ST MONTEFIORE MEDICAL CENTER
Provider Second Line Business Practice Location Address:
KLAU 2 PSYCHIATRY
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-920-4737
Provider Business Practice Location Address Fax Number:
718-405-0401
Provider Enumeration Date:
11/08/2006