Provider First Line Business Practice Location Address:
462 1ST AVENUE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PSYCHIATRY, NYU LANGONE MEDICAL CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-263-6219
Provider Business Practice Location Address Fax Number:
212-263-6483
Provider Enumeration Date:
02/07/2011