Provider First Line Business Practice Location Address:
227 MADISON STREET
Provider Second Line Business Practice Location Address:
GOUVERNEUR HOSPITAL (DEPT OF REHAB SERVICES)
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-238-7897
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2008