Provider First Line Business Practice Location Address:
317 E 17TH ST STE 5F-09
Provider Second Line Business Practice Location Address:
BETH ISRAEL MEDICAL CENTER - FIERMAN HALL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-3804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-420-4230
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2007