Provider First Line Business Practice Location Address:
75 NEW SCOTLAND AVE
Provider Second Line Business Practice Location Address:
CDPC - CHILD AND ADOLESCENT SERVICE
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12208-3409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-447-9647
Provider Business Practice Location Address Fax Number:
518-426-2902
Provider Enumeration Date:
01/07/2011