Provider First Line Business Practice Location Address:
630 W 168TH ST
Provider Second Line Business Practice Location Address:
DEPARTMENT OF ANESTHESIOLOGY, PH 527-B
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-305-8633
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2012