Provider First Line Business Practice Location Address:
1556 STRAIGHT PATH
Provider Second Line Business Practice Location Address:
HUDSON RIVER HEALTHCARE, INC.
Provider Business Practice Location Address City Name:
WYANDANCH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11798-3213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-214-8020
Provider Business Practice Location Address Fax Number:
631-643-1590
Provider Enumeration Date:
07/15/2015