Provider First Line Business Practice Location Address:
BETH ISRAEL MEDICAL CENTER/PETRIE DIVISION
Provider Second Line Business Practice Location Address:
1ST AVENUE AT 16TH ST.
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-420-2385
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006