Provider First Line Business Practice Location Address:
170 W 12TH STREET NR408
Provider Second Line Business Practice Location Address:
ST VINCENT CATHOLIC MEDICAL CENTERS
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10011-8202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-604-7566
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2008