Provider First Line Business Practice Location Address:
535 8TH AVE.
Provider Second Line Business Practice Location Address:
2ND FLOOR, LOS NINOS SERVICES
Provider Business Practice Location Address City Name:
NEW YORK CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-787-9700
Provider Business Practice Location Address Fax Number:
212-787-4418
Provider Enumeration Date:
12/22/2008