Provider First Line Business Practice Location Address:
445 PARK AVE
Provider Second Line Business Practice Location Address:
CHILD MIND INSTITUTE
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10022-2606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-625-4360
Provider Business Practice Location Address Fax Number:
646-625-4352
Provider Enumeration Date:
03/29/2012