Provider First Line Business Practice Location Address:
630 WEST 168TH STREET
Provider Second Line Business Practice Location Address:
DEPARTMENT OF INTERNAL MEDICINE
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:
347-613-9645
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/07/2021