Provider First Line Business Practice Location Address:
506 MALCOLM-X BLVD
Provider Second Line Business Practice Location Address:
HARLEM HOSPITAL, DEPT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-939-3067
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2012