Provider First Line Business Practice Location Address:
130 WEST KINGSBRIDGE ROAD (00MH)
Provider Second Line Business Practice Location Address:
JAMES J PETERS VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10468
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-584-9000
Provider Business Practice Location Address Fax Number:
718-741-4703
Provider Enumeration Date:
08/05/2006